Pneumothorax recurrence symptoms

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on January 07, 2025
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We know that normally there is no air in the pleural cavity, only a small amount of fluid or lubricant exists. However, in certain people, such as those who often smoke, tall and thin young people, and patients with chronic bronchitis, the alveoli in their lungs tend to be more fragile and can easily rupture. People experiencing a pneumothorax for the first time might feel this during certain situations like after a cold, coughing, sneezing, or playing sports, which can lead to a recurrence of the pneumothorax. Early symptoms of a recurrence, due to only a small amount of air compression, might not be very uncomfortable, just a slight sense of difficulty breathing. As the pneumothorax increases, symptoms like chest pain and difficulty breathing can develop. Therefore, the symptoms of a recurring pneumothorax are not identical each time, but there is a pattern; the severity can range from mild breathing difficulty to severe respiratory distress and chest pain.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pneumothorax recurrence symptoms

We know that normally there is no air in the pleural cavity, only a small amount of fluid or lubricant exists. However, in certain people, such as those who often smoke, tall and thin young people, and patients with chronic bronchitis, the alveoli in their lungs tend to be more fragile and can easily rupture. People experiencing a pneumothorax for the first time might feel this during certain situations like after a cold, coughing, sneezing, or playing sports, which can lead to a recurrence of the pneumothorax. Early symptoms of a recurrence, due to only a small amount of air compression, might not be very uncomfortable, just a slight sense of difficulty breathing. As the pneumothorax increases, symptoms like chest pain and difficulty breathing can develop. Therefore, the symptoms of a recurring pneumothorax are not identical each time, but there is a pattern; the severity can range from mild breathing difficulty to severe respiratory distress and chest pain.

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Written by Wang Xiang Yu
Pulmonology
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Pneumothorax should be registered under which department?

What department should you register for pneumothorax? If pneumothorax occurs suddenly, the condition is generally severe with significant breathing difficulties. In such cases, we recommend prioritizing a visit to the emergency department. Once the emergency department receives the patient, they will immediately request a consultation with a thoracic surgeon or a respiratory specialist. If the patient requires surgery, such as thoracic closed drainage or other procedures, it is usually handled by a thoracic surgeon; if the patient only requires conservative treatment, they will likely be transferred to the respiratory department; if the patient's condition is critical, they might be admitted to the ICU.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Causes of pneumothorax

The causes of pneumothorax vary with age. In young people, the condition often occurs in tall, thin individuals, somewhat akin to a balloon. We can liken the lung to a balloon: for shorter, heavier individuals, the balloon is rounder and experiences more uniform stress, whereas for tall, thin individuals, it's as if the balloon is being stretched vertically. Therefore, the tips of the balloon (or the lung) in tall, thin individuals are more prone to rupture. Additionally, for tall, thin individuals, the blood supply to the apical alveoli may not be as robust, making them more susceptible to micro-ruptures. Microscopic anatomical structures have also proven that there are tiny pores in the apical bubble tissues in these individuals. In older adults, the causes of pneumothorax are usually underlying lung diseases, such as chronic smoking, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and other conditions like tuberculosis or HIV infections can also lead to pneumothorax. Some cases are due to traumatic causes like physical injuries or stab wounds, which can lead to secondary or iatrogenic pneumothorax. In summary, while the causes of pneumothorax vary by age, in young people, it more commonly stems from being tall and thin. In older individuals, smoking, tobacco use, chronic bronchitis, and infections are more common causes.

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Written by Xia Bao Jun
Pulmonology
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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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Written by Xia Bao Jun
Pulmonology
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How is pneumothorax treated?

The treatment of pneumothorax aims to promote the reexpansion of the affected lung and reduce recurrence, while considering the possibility of eliminating the cause of the disease. Treatment measures include non-surgical and surgical treatments. Non-surgical measures include observation, thoracic puncture for air evacuation, closed thoracic drainage, and pleural fixation. Surgical treatments include thoracoscopic surgery and open chest surgery. Choices should be made based on the type and frequency of occurrence of the pneumothorax, the degree of compression, the state of the condition, and the presence of complications, etc. Most patients can be cured through non-surgical treatment, while only a minority, approximately 10%-20% of patients, require surgical treatment.