Spontaneous pneumothorax
What is it?
This is the presence of air in the pleural space (which is usually the potential space between two pleuraes, one that lines the chest wall and the other that lines the lung), followed by collapse of the lung. It can be primary, i.e. in the absence of lung disease, or secondary, i.e. caused by lung disease.
Causes and risk factors
Primary pneumothorax is caused by the spontaneous rupture of small bubbles, usually located in the tops of the lungs, which may be caused by smoking. Secondary pneumothorax is caused by diseases of the lungs, particularly emphysema. Primary pneumothorax is typical of men, young (15 to 24 years old), tall and slender. In women of childbearing age, pneumothorax can occur simultaneously with the menstrual cycle (menstrual pneumothorax). Secondary penumothorax is characteristic of old age and directly correlates with pathologies that develop with age.
Which are the symptoms?
The patient may complain of shortness of breath and stabbing chest pains. An irritating cough may be present.
How is it diagnosed?
A chest X-ray detects air in the pleural space. A CT scan of the chest may show the presence of blisters on the surface of the lungs and / or the presence of pleuro-pulmonary lesions.
Suggested exams
How is it treated?
If lung collapse is less than 20%, the patient is in good general condition and with mild symptoms, the pneumothorax may resolve spontaneously and the patient is only monitored. If the collapse of the lung exceeds 20%, a thoracic drainage tube is inserted to allow air to escape and then re-expand the lungs. In the first episode, there is a surgical indication if there are persistent air leaks from the chest drain (more than 48-72 hours) or if the patient is performing work that requires important changes in pressure balance (as for pilots or divers). Starting from the second episode of pneumothorax (even if it is opposite to the first), there is always an indication for surgical intervention. Surgical treatment usually consists of resection of the pulmonary vesicles and a pleurodesis procedure to obtain adhesion between the two pleura. The operation is always performed using a minimally invasive method using videothoracoscopy.
Where do we treat it?
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