What is a pneumothorax?

By | 8 May 2021

Various health problems can lead to serious problems, sometimes life-threatening. It is possible to prevent such situations by having accurate and sufficient information about these problems and the reasons that lead to the problem. Pneumothorax is one of the important health problems to be prepared for when it occurs under certain conditions in daily life.

What is a pneumothorax?

Pneumothorax; refers to the escape of the air in the lung from the lung to the extrapulmonary tissue layer due to various effects. In this case, the air compresses the lung by filling the space between the lungs in the thorax, and the lung contracts by losing air. That can turn into an important problem that can sometimes be life-threatening depending on the area and effect it occurs. In addition, small-scale pneumothorax may not cause a serious symptom or cause a major health problem.

What causes pneumothorax?

In general, pneumothorax, in the presence of cystic or weakened lung walls, as a result of various external or internal factors forcing or damaging the lung tissue; develops as a result of the air accumulated in these tissues escaping to the lungs. However, pneumothorax is basically divided into six according to how it occurs:

Primary pneumothorax: It is a type of pneumothorax that develops spontaneously and the presence of a significant factor cannot be mentioned. It is frequently observed in tall, slender, young men. There may be an underlying structural health problem.
Secondary pneumothorax: It is the type that develops as a result of air leakage of cystic structures in the lungs as a result of various health problems (COPD, emphysema, etc.).
Simple pneumothorax: Simple pneumothorax is mentioned when no significant tissue and organ movement or damage is observed despite the air escape in the lung.
Open pneumothorax: It is the condition in which the lung is damaged by external effects and air escapes directly to the external environment. In this condition, the lung completely deflates and the other lung shifts towards the extinct side. It is a condition that needs to be intervened quickly with appropriate treatment.
Tension pneumothorax: It is the type that results in the compression of the air in the chest and chest, acting as a valve, as a result of damage to the lung, especially in high-energy pulses coming to the lung from outside. This valve results in increased air escaping with each breath and complete extinguishing of the damaged lung. The accumulated air, on the other hand, gradually compresses the internal organs and prevents the blood circulation of the organs. It is a serious life-threatening emergency that, if not treated immediately, can result in heart failure and death.
Traumatic pneumothorax: It refers to open pneumothorax, which often occurs as a result of diagnostic or therapeutic interventions in the lung.

What are the causes of pneumothorax?

The factors that cause It may be related to diseases in the body as well as some environmental factors. These reasons can be summarized as follows:

  • Lung diseases: Health problems that cause lung tissue degradation, such as chronic obstructive pulmonary disease (COPD) and emphysema, increase the risk.
  • Trauma: In high-energy traumatic situations such as a traffic accident, falling from a height, lung tissue is directly damaged and leads to severe cases of it. In addition, some medical interventions such as collisions in sports events, injuries with guns or sharp objects, fractures of the ribs, or heart massage can also cause it.
  • Mechanical ventilation: The respiratory support device is a medical device that should be used in people with respiratory failure. However, ventilation devices that are not properly adjusted can damage lung tissue by delivering high-pressure air.
  • Air cysts (bulla): Air-filled cysts that develop secondary to various lung problems may burst spontaneously or due to environmental factors and may cause pneumothorax.
  • Menstrual periods: Especially 3 days before the start of menstruation and between the first days of menstruation, air cysts may form in the lungs and create a risk of pneumothorax.
  • Smoking: Smoking directly disrupts the structure of the lung wall and increases the risk of developing pneumothorax.
  • Genetics: In genetically based syndromes such as Marfan or Ehler-Danlos, easy pneumothorax occurs because the lung structure will develop impaired.

What are the symptoms of pneumothorax?

Pneumothorax is clinically recognized by producing the following symptoms:

  • Sudden chest pain; A sudden, stabbing pain is felt especially in the area where the pneumothorax occurred. It should be distinguished from pressing, overwhelming cardiac pain.
  • Shortness of breath; Air hunger is felt according to the degree of extinction in the lung.
  • Cough; Cough reflex may develop due to lung shrinkage with air hunger.
  • Rapid breathing; The respiratory rate increases to close the air hunger that occurs
  • Palpitation; Pulse accelerates due to the effects of the air accumulated with the contracting lung on the heart.
  • Weakness; Fatigue may develop due to air loss.
  • Bruising; In case of prolonged and severe air loss, bruising may be observed throughout the body due to oxygen deficiency.

How is pneumothorax diagnosed?

Diagnosing It can be vital in emergencies. The diagnosis of tension pneumothorax is made according to clinical symptoms and treatment is planned accordingly. Especially with deteriorating vital signs, history of trauma; should definitely be suspected in people with complaints of impaired consciousness, palpitations, rapid breathing, low blood pressure, and shortness of breath.

In addition, chest x-ray and tomography are used in cases with more stable and ambiguous symptoms. In this way, the diagnosis of underlying health problems in the lungs becomes easier.

What is done in the treatment of pneumothorax?

The intervention to be made to the pneumothorax determines the severity of the case. In cases of simple and small-scale pneumothorax, since no problem threatens life or causes permanent damage to the patient, follow-up treatment can be performed. However, in serious cases such as tension, immediate intervention should be made.

  • In simple cases of It, the patient is followed under the supervision of a doctor. What is expected here is that the small amount of air in the chest cavity is absorbed spontaneously and the damage is repaired by the body.
  • Again, depending on the amount of air accumulated, with the help of thoracentesis or needle aspiration method, the deflated lung can be filled with air by evacuating the air with a syringe.
  • In cases of more severe or open pneumothorax, the patient’s findings are stabilized, a chest tube is inserted into the rib cage between the ribs and underwater drainage is performed. The aim is to evacuate the air leaking into the rib cage and allow the deflated lung to fill with air again.
  • In cases of recurrent pneumothorax, the pleura (pleura) is fixed to the lung tissue with various operations so that the patient does not have an attack again, and possible leaks are prevented.
  • In blood pressure that cases, the first aim is to eliminate the “valve” mechanism. For this, the patient’s closed pneumothorax condition is turned into an open pneumothorax by connecting the chest cavity to the outside. In this way, the air accumulated in the rib cage is taken out, preventing it from compressing the internal organs. Then, an approach to open pneumothorax is applied to the patient.
  • Surgical methods are preferred for direct repair of the damage in major lung injuries.
  • Surgical methods can be applied in lung problems such as air cysts or emphysema. The aim here is to reduce the risk of pneumothorax by removing the cysts surgically. In severe cases, the lobes of the lung can also be surgically removed.

Generally, complete recovery of it can take 6-8 weeks. In addition, people who have had pneumothorax have an increased risk of having a second pneumothorax compared to healthy individuals.

Patients can take various precautions to prevent recurrence of pneumothorax after treatment:

  • Smoking should be stopped. Smoking seriously increases the risk of pneumothorax by causing emphysema and air cysts.
  • Activities that may cause high-pressure variations, such as deep underwater diving or air travel, should be delayed; If necessary, act according to the doctor’s advice.
  • People with known lung problems must act under the supervision of a doctor and follow their treatment.

If you have a pneumothorax complaint, you can apply to your nearest health facility to be evaluated by a specialist physician.

 

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