PNEUMOTHORAX

Definition

An abnormal collection of air or

gas in the pleural space separating the
lung from the chest wall which may
interfere with normal breathing,
causing the lungs to collapse
 TYPES

SPONTANEOUS PNEUMOTHORAX
Primary:
It occurs in young healthy individuals without underlying lung
disease. It is due to rupture of apical sub- pleural bleb.
Secondary:
occurs in the presence of pre- existing lung pathology. Ex : Cystic
lung disease ,COPD, LUNG CANCER &TB
 TRAUMATIC PNEUMOTHORAX

Open:
Chest wall is damaged by any wound - -outside air enters pleural
space and causes lungs to collapse.
Closed:
chest wall is punctured or air leaks from a ruptured bronchus
Iatrogenic :
Ex. Postoperative Mechanical ventilation, Thoracocentesis
& Central venous cannulation .
 TENSION PNEUMOTHORAX

It is life threatening condition…The pleural pressure is more than the

atmospheric pressure. Associated with clinical manifestations of circulatory
collapse (tachycardia, hypotension & sweating). It is more common with 
Positive pressure ventilation &  Traumatic 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.
CLINICAL FEATURES

 acute pleuritic chest pain

 Dyspnoea results form pulmonary compression
 On physical examination:
 Breath sounds may be diminished on the affected side
 Percussion of the chest may be perceived as hyperresonant.
 Physical signs include
 Tachypnoea. Increased resonance
 Absent breath sounds. Hypoxemia
Cyanosis. Hypercapnia
 RISK FACTORS

Sex: men are far more likely to have a pneumothorax than are women.
Smoking.
Age:The type of pneumothorax caused by ruptured air blisters is most likely to occur in
people between 20 and 40 years old, especially if the person is a very tall and underweight
man.
Genetics.
Lung disease. Having an underlying lung disease — especially chronic obstructive pulmonary
disease (COPD) — makes a collapsed lung more likely.
Mechanical ventilation.
history of pneumothorax
DIAGNOSIS- CHEST XRAY
CT SCAN
 TREATMENT
GOALS:
To promote expansion.
To eliminate the pathogenesis.
To decrease pneumothorax recurrence.
Treatment options :
Simple aspiration
Intercostal tube drainage
Guidewire tube thoracostomy
ASPIRATION
ICD
CHEST TUBE
THANK YOU