(See also Introduction to Chest Injuries Introduction to Chest Injuries Chest injuries most often affect the ribs, upper part of the abdomen, lungs, blood vessels, heart, muscles, soft tissues, and breastbone. Sometimes the esophagus, collarbone, or shoulder blade... read more .)
Pneumothorax may result when blunt force (such as a motor vehicle crash or fall) or a penetrating injury (such as a stab or gunshot wound) damages the lungs and/or airways. The damage allows air to leave the lung and collect between the lung and the wall of the chest. Air from the pneumothorax may also leak into the skin of the chest or neck. Many people also have blood in the pleural space (hemopneumothorax).
Pneumothorax of both lungs is very dangerous. However, most often only one lung is affected. A pneumothorax that affects only one lung is rarely dangerous unless people have a chronic lung disorder (such as asthma Asthma Asthma is a condition in which the airways narrow—usually reversibly—in response to certain stimuli. Coughing, wheezing, and shortness of breath that occur in response to specific triggers are... read more or COPD [chronic obstructive pulmonary disease] Chronic Obstructive Pulmonary Disease (COPD) Chronic obstructive pulmonary disease is persistent narrowing (blocking, or obstruction) of the airways occurring with emphysema, chronic obstructive bronchitis, or both disorders. Cigarette... read more ) or unless the pneumothorax is a tension pneumothorax Tension Pneumothorax Tension pneumothorax occurs when air accumulates between the chest wall and the lung and increases pressure in the chest, reducing the amount of blood returned to the heart. Symptoms include... read more or an open pneumothorax Open Pneumothorax An open pneumothorax occurs when air accumulates between the chest wall and the lung as the result of an open chest wound or other physical defect. The larger the opening, the greater the degree... read more (a pneumothorax that connects to an open wound in the chest wall).
People have chest pain. Most of the pain is due to the injury that caused the pneumothorax. They may feel short of breath or breathe rapidly and feel that their heart is racing, particularly if the amount of air is large.
If air accumulates under the skin, the skin feels crackly and makes a crackling sound when touched.
Doctors usually diagnose a pneumothorax based on a chest x-ray X-Rays of the Chest Anyone thought to have a heart disorder has chest x-rays taken from the front and the side. Typically, the person is standing upright, but chest x-rays can be done with people lying in bed if... read more . Sometimes pneumothorax is diagnosed when CT or ultrasonography is done to diagnose other chest or abdominal injuries.
The goal of treatment is to remove the air from the pleural space and allow the lung to reinflate. Usually, a tube (thoracostomy Chest Tube Insertion Chest tube insertion (also called tube thoracostomy) is a procedure in which a tube is inserted into the space between the lung and chest wall (called the pleural space). The procedure is done... read more or chest tube) is inserted into the chest between two ribs. The tube is attached to a suction device to remove the air and to allow the lung to reinflate. This procedure can be done using only a local anesthetic.
However, if the amount of air is small and causes no symptoms, doctors may not remove the air at all, because a small pneumothorax Pneumothorax A pneumothorax is the presence of air between the two layers of pleura (thin, transparent, two-layered membrane that covers the lungs and also lines the inside of the chest wall), resulting... read more often goes away on its own. Or doctors may insert a small catheter (drain) to remove the air. Whatever the treatment, doctors typically keep the person in the hospital for observation to make sure the pneumothorax does not worsen.