This document discusses pneumothorax, beginning with a definition and overview of types including spontaneous, traumatic, and tension pneumothorax. Risk factors are identified such as male sex, smoking, age, genetics, and lung disease. Diagnosis involves physical exam findings and imaging tests like chest x-ray and CT scan. Treatment goals are promoting lung expansion and eliminating causes, using methods such as aspiration, tube drainage, or surgery. Complications are also reviewed.

1. By: M. Suleiman Aljajeh
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2014-2015

2. 1. Definition
2. Types
3. Clinical features
4. Risk factors
5. Diagnosis
6. Treatment
7. Complications
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3.  “Pneumothorax : is 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.”
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4. 1. 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 &T.B
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5. 2. Traumatic pneumothorax:
 Open: Chest wall is damaged by any wound -
-outside air enters pleural space and causes
lungs to collapse.
 Closed: here chest wall is punctured or air
leaks from a ruptured bronchus
 Iatrogenic : Ex. Postoperative Mechanical
ventilation ,Thoracocentesis & Central
venous cannulation .
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6. 3. Tension pneumothorax:
 It is life threatening condition…The pleural
pressure is more than the atmospheric pressure.
 Radiological manifestations of large
pneumothorax :
Mediastinal shift,
Flattening of the hemidiaphragm &
Lung collapse.
Associated with clinical manifestations of
circulatory collapse (tachycardia, hypotension &
sweating).
It is more common with
 Positive pressure ventilation &
 Traumatic pneumothorax. 6
ER

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8. The pleural cavity
pressure is < the
atmospheric
pressure
The pleural cavity
pressure is = the
atmospheric
pressure
The pleural cavity
pressure is > the
atmospheric pressure
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9.  Predominant symptom is 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 9

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12.  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.
 A history of pneumothorax.
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13.  The characteristics of
pneumothorax
 Pleural line
 No lung markings in
pneumothorax
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14.  A further use of CT is in the identification of
underlying lung lesions
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15. Goals :
To promote lung expansion.
To eliminate the pathogenesis.
To decrease pneumothorax
recurrence.
 Treatment options :
 Simple aspiration
 Intercostal tube drainage
 Guidewire tube thoracostomy
 Surgical treatment
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19. Complications of pneumothorax
Recurrence of spontaneous pneumothorax
Tension pneumothorax
Hydropneumothorax
Encysted pneumothorax
Failure of expansion of the collapsed lung
Re-expansion pulmonary edema
Broncho-pleural fistula
Pneumomediastinum 19

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1. Kumar and Clark Clinical Medicine
2. USMLE Step 2 CK
3. Harrison's Principles of Internal Medicine

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