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Collapsed lung (Pneumothorax)
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Collapsed lung (Pneumothorax)

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Air around the lung; Air outside the lung; Pneumothorax; Spontaneous pneumothorax

A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung, between the lung and chest wall. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath.

The medical name of this condition is pneumothorax.

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  • Causes

    Collapsed lung can be caused by an injury to the lung. Injuries can include gunshot or knife wound to the chest, rib fracture, or certain medical procedures.

    In some cases, a collapsed lung is caused by air blisters (blebs) that break open, sending air into the space around the lung.This can result from air pressure changes such as when scuba diving or traveling to a high altitude.

    Tall, thin people and smokers are more likely to have a collapsed lung.

    Lung diseases can also increase the chance of getting a collapsed lung. These include:

    • Asthma
    • COPD
    • Cystic fibrosis
    • Tuberculosis
    • Whooping cough

    In some cases, a collapsed lung occurs without any cause. This is called a spontaneous pneumothroax or collapsed lung.

  • Symptoms

    Common symptoms of a collapsed lung include:

    • Sharp chest pain, made worse by a deep breath or a cough
    • Shortness of breath
    • Nasal flaring 

    A larger pneumothorax causes more severe symptoms, including:

    • Bluish color of the skin due to lack of oxygen
    • Chest tightness
    • Easy fatigue
    • Rapid heart rate
  • Exams and Tests

    The health care provider will listen to your breathing with a stethoscope. If you have a collapsed lung, there are decreased or no breath sounds on the affected side. You may also have low blood pressure.

    Tests that may be ordered include:

    • Arterial blood gases
    • Chest x-ray 
  • Treatment

    A small pneumothorax may go away on its own. You may only need oxygen treatment and rest.

    The health care provider may use a needle to pull the extra air out from around the lung so it can expand more fully. You may be allowed to go home if you live near the hospital.

    If you have a large pneumothorax, a chest tube will be placed between the ribs into the space around the lungs to help drain the air and allow the lung to re-expand. The chest tube can be left in place for several days. You may need to stay in the hospital. If a small chest tube or flutter valve is used, you may be able to go home. You will need to return to the hospital to have the tube or valve removed.

    Some patients with a collapsed lung need extra oxygen.

    Lung surgery may be needed to treat collapsed lung or to prevent future episodes. The area where the leak occurred may be repaired. Sometimes, a special chemical is placed into the area of the collapsed lung. This chemical causes a scar to form. This procedure is called pleurodesis.

  • Outlook (Prognosis)

    If you have a collapsed lung, you are more likely to have another one in the future if you:

    • Are tall and thin
    • Continue to smoke
    • Have had two collapsed lungs in the past

    How well you do after having a collapsed lung depends on what caused it.

  • Possible Complications

    • Another collapsed lung in the future
    • Shock
  • When to Contact a Medical Professional

    Call your health care provider if you have symptoms of a collapsed lung, especially if you have had one before.

  • Prevention

    There is no known way to prevent a collapsed lung. You can decrease your risk by not smoking.

Related Information

  Chronic obstructiv...AsthmaCystic fibrosisPulmonary tubercul...Pertussis     Asthma in adults...

References

Byyny RL, Shockley LW.  Scuba diving and dysbarism. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Elsevier Mosby; 2009:chap 141.

Kirsch TD, Sax J. Tube thoracostomy. In: Roberts JR, Hedges JR, eds. Roberts & Hedges’ Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2013:chap 10.

Light RW, Lee GY. Pneumothorax, chylothorax, hemothorax, and fibrothorax. In: Mason RJ, Murray JF, Broaddus VC,  et al., eds. Murray and Nadel’s Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Elsevier Saunders; 2010:chap 74.

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Review Date: 7/20/2013  

Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Editorial update 01-31-2014. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team

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