Pneumothorax, which department should it go to?

Written by Wang Xiang Yu
Pulmonology
Updated on September 28, 2024
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Which department is better for pneumothorax treatment? There isn't a strict definition dictating which specific department one must visit for pneumothorax. Generally, you can visit the respiratory department or the cardiothoracic surgery department. If the patient's condition is very severe, then the first choice should be the emergency department, where emergency treatment can be provided before further referral.

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Written by Han Shun Li
Pulmonology
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Is pneumothorax the same as emphysema?

Pneumothorax and emphysema can both manifest symptoms such as chest tightness, difficulty breathing, and coughing. However, is pneumothorax the same as emphysema? Pneumothorax and emphysema are two different diseases. Simply put, pneumothorax is a pleural disease caused by a rupture of the pleura, while emphysema is a disease of the airways. When a lung is imaged for pneumothorax, the film shows lung compression. It is possible to see the external boundary of the compressed lung where pneumothorax is present, with no lung markings. In the case of emphysema, imaging shows that the thoracic cage is expanded, with widened intercostal spaces, and increased translucency in both lung lobes. Therefore, the differences between pneumothorax and emphysema are significant, and they are not the same disease.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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The difference between tension pneumothorax and open pneumothorax.

The main difference between a tension pneumothorax and an open pneumothorax lies in the relative pressures of the pleural cavity compared to the atmospheric pressure. An open pneumothorax occurs when the pleural cavity is in an open state due to some reason. During inhalation, gas can enter the pleural cavity, and during exhalation, the gas can be expelled through this opening or another opening, resulting in pleural cavity pressure that is roughly equal to the atmospheric pressure. In a tension pneumothorax, due to some reason, a one-way valve is formed. The gas enters the pleural cavity easily but encounters resistance during expulsion, causing the pressure in the patient's pleural cavity to increase progressively. The gas can only enter the pleural cavity and cannot be effectively expelled. Therefore, the main difference between a tension pneumothorax and an open pneumothorax is the level of pleural cavity pressure compared to atmospheric pressure; in a tension pneumothorax, the pressure in the pleural cavity is significantly higher than the atmospheric pressure, while in an open pneumothorax, the pressures are roughly equal.

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Written by Xia Bao Jun
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Pneumothorax tracheal shift to which side?

When a patient suffers a pneumothorax, the trachea is displaced to the opposite side, and the heart is also shifted to the opposite side. In cases of left-sided pneumothorax, the heart's dullness boundary and the upper boundary of the liver during right-sided pneumothorax are both undetectable. There can be manifestations of subcutaneous emphysema in the neck, chest, and even the head and abdomen. The patient may exhibit diminished respiratory movements and a significant reduction or absence of breath sounds. When a small amount of air accumulates in the pleural cavity, weakened breath sounds on the affected side may be the only suspicious sign.

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The fastest method for spontaneous pneumothorax recovery.

Pneumothorax is mainly caused by various reasons that allow air inside the lungs to enter the pleural cavity, resulting in the accumulation of gas and the compression of the lung, reducing its volume. Clinically, for patients with lung compression not exceeding 30%, a conservative approach is typically chosen, which involves allowing the patients to heal naturally. For these patients who wish to accelerate their recovery, it is generally recommended to inhale high concentrations of oxygen, which can aid in the healing of the lungs. Additionally, it is important to increase nutrition and protein intake to enhance lung repair and recovery.

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How to check for hemothorax and pneumothorax?

Actually, the examination methods for hemothorax and pneumothorax are quite simple. From their definitions, we know that hemothorax means the abnormal presence of blood in the pleural cavity, and pneumothorax means the presence of gas in the pleural cavity where it shouldn't be. Therefore, the simplest examination is an X-ray, a standard frontal and lateral chest X-ray, which usually costs about 52 yuan, can detect whether a patient has pneumothorax. As for hemothorax, of course, it involves the use of a syringe. After injecting some lidocaine local anesthesia into the patient, if blood is withdrawn from the pleural cavity, then it indicates a hemothorax. Thus, the first step in examining for hemothorax and pneumothorax is to perform an X-ray to check for the presence of gas. If gas is detected, then it is pneumothorax. If liquid is found, a syringe under ultrasound guidance can be used to withdraw it. If the withdrawal yields fluid, it indicates pleural effusion; if blood is drawn, then it indicates hemothorax.