As the healthy lung expands and contracts, each layer of the pleura glides without friction on the greased surface of another. A pneumothorax occurs when air enters the pleural space between the two layers and force them to separate. Therefore lung – or, more likely, part of the lungs – collapses (i.e. loses its elasticity and therefore remains without air). The cause of these problems can be chest injuries or, as often, the air can get into the pleura from the lungs. A small pneumothorax will often disappear by itself; however, sometimes more air enters the pleural space, resulting in the collapse of a bigger part of the lung.
The main symptoms are shortness of breath and chest pain, usually on one side, and sometimes at the bottom of the neck. The pain is usually sudden and penetrating, though sometimes a person can feel only slight discomfort in the chest.
In some cases, the patient feels tension in the chest. Severity of symptoms depends on the size of the damaged area and on general health. If you are young and healthy, you might feel a slight pain and small problems while breathing, even though you have a strong pneumothorax and a large area collapsed lung. If you are middle-aged and have chronic bronchitis, a small pneumothorax can be very painful and cause acute breathing difficulties.
Pneumothorax is relatively rare. In an average year, about one in 5000 people sees the doctor because of this disease. It occurs mainly in otherwise healthy young men (no one knows why) and middle aged individuals (men and women) whose lungs are already damaged by asthma, chronic bronchitis, emphysema or other serious lung diseases.
In the assessment of risk, the most important are the ways of penetration of the air in the pleura. A small pneumothorax often leaves no consequences and disappears by itself. But if there is an opening that allows the increase of pneumothorax, it will cause excessive loss of breath and stronger pain as the lung collapses even more. If the disorder is not treated, a respiratory failure will probably occur.
What to do?
If you think you have a pneumothorax, consult your doctor. By examing the chest with a stethoscope, a doctor will quickly discover a large pneumothorax, but you will need an X-ray of the chest to detect small pneumothorax. In any case, even if he only suspects, the doctor will probably refer you to hospital treatment.
Treatment depends on the size of the pneumothorax and lung condition. Because the disorder often goes by itself, you might need a few days of x-ray monitoring and lying whil ewaiting for a pleural air to go out and collapsed lung provided with air. If necessary, the treatment consists in taking measures of sucking the pleural air by a tube (catheter), which is inserted between the ribs into the pleural cavity. If catheterization does not help, your doctor will need to further investigate the cause of the problems, and will use thoracoscope to inspect the inside of each layer of the pleura. When specialist draws thoracoscopy between the ribs in the pleural cavity, he will find an opening through which the air penetrates and close it by chemical means.