Can pneumothorax heal by itself?

Written by Han Shun Li
Pulmonology
Updated on October 24, 2024
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Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural cavity, and it is relatively common clinically. Can pneumothorax be cured after it occurs? It depends on the specific circumstances. If it is a closed pneumothorax with a small amount of air accumulation, conservative treatments like rest and oxygen therapy can allow for self-healing of the pneumothorax. However, in most cases, the accumulation of air is generally significant, and often it is a tension pneumothorax. In these instances, treatments generally involve pleural cavity puncture, or closed pleural drainage to drain the air, making it difficult to heal spontaneously and requiring medical treatment. Moreover, some patients may not recover fully despite aggressive treatment and may require surgical intervention.

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Written by Li Hu Chen
Imaging Center
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How to Read a Pneumothorax X-ray

Pneumothorax has typical manifestations on a chest X-ray. Normally, the pulmonary markings on both sides are quite clear and visible. However, when a pneumothorax occurs, the part of the lung tissue with these markings tends to be compressed due to the accumulation of a large amount of gas in the surrounding pleural cavity, pushing the lung to contract towards the center. Around the periphery, these lung margins, which are outside the lung, meaning inside the pleural cavity, display the gas as very uniform and fine, without any markings. This is because it is pure gas, simply air, hence it is impossible for it to have markings. There is a particularly distinct demarcation line, a thin line, between this part of the pleural cavity and the lungs. Through these features, one can determine the presence of a pneumothorax.

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Written by Han Shun Li
Pulmonology
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Pneumothorax should go to which department?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural cavity, leading to symptoms such as coughing, chest pain, and chest tightness. If there is a substantial amount of air accumulation, the symptoms can be quite pronounced, and severe cases can lead to respiratory failure and hypoxia. If one seeks medical attention for a pneumothorax, they could visit either the respiratory medicine department or thoracic surgery department. After consulting a doctor, treatment may involve procedures like pleural cavity puncture for air extraction or pleural cavity tube drainage to relieve the symptoms of pneumothorax as quickly as possible.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pneumothorax should be seen by which department?

If it is the patient's first pneumothorax occurrence and they are relatively young with no obvious lung bullae on the surface of their lungs, then seeing the emergency department should be sufficient to resolve the issue. Generally, if less than 20% of the lung is compressed, the patient can simply breathe oxygen at home or at a community hospital to gradually recover. However, if the patient is older and the degree of pneumothorax exceeds 20%, even reaching above 30%, it is advisable to insert a small tube between one and two millimeters into the pleural cavity to extract the air. At this point, it is recommended to consult thoracic surgery. After the air is released, a CT scan is also necessary to check for obvious lung bullae or small tears on the lung surface. If a small tear is found, it is best to use minimally invasive thoracoscopy to suture or seal the tear to prevent recurrence. Therefore, if possible, directly consider consulting thoracic surgery for pneumothorax; if thoracic surgery is not available, then consider seeing the emergency department.

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Written by Han Shun Li
Pulmonology
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Can you smoke with pneumothorax?

After suffering from pneumothorax, patients often experience symptoms such as chest pain, chest tightness, and coughing. Can patients smoke after suffering from pneumothorax? It is advised against smoking after suffering from pneumothorax, as smoke and harmful substances directly irritate the respiratory tract, worsening the patient's symptoms. Additionally, smoking produces a large amount of carbon monoxide, which, when absorbed by the body, can cause hypoxia, thereby exacerbating symptoms of breathing difficulty. Therefore, patients with pneumothorax should not smoke, and it is also recommended to quit smoking even after recovery from pneumothorax, as smoking is harmful in many ways and particularly damaging to the respiratory system.

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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 difference in pressure. If the pressure inside the pleural cavity is approximately the same as the atmospheric pressure, it is referred to as an open pneumothorax. In this case, typically after an injury, the wound allows air to freely enter and exit during breathing. When inhaling, air can enter the pleural cavity, and the air can be expelled during exhalation. At this time, because the system opens and closes with each inhale and exhale, the pressure is roughly equal to atmospheric pressure. On the other hand, in a tension pneumothorax, under certain conditions, when air enters the pleural cavity and cannot escape during exhalation, such as when a sort of flap forms, for example after a trauma causing a rupture in the bronchus or trachea, this flap prevents the expulsion of air from the pleural cavity. Therefore, the pressure in the pleural cavity continues to increase, significantly higher than atmospheric pressure. This is the difference between a tension pneumothorax and an open pneumothorax.