The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

Skip to main content

Pneumothorax

Air accumulation in the pleural space causing lung collapse

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göğüs Hastalıkları department. Book Appointment →

What is Pneumothorax?

Pneumothorax is defined as the presence of air in the pleural space between the visceral and parietal pleura, leading to loss of the normal negative pressure and varying degrees of lung collapse. It is classified by etiology: primary spontaneous (PSP, without clinically apparent lung disease), secondary spontaneous (SSP, underlying lung disease), traumatic, and iatrogenic.

Primary spontaneous pneumothorax typically occurs in tall, thin, young adult male smokers due to rupture of apical subpleural blebs. Secondary spontaneous pneumothorax occurs in patients with underlying disease (COPD, cystic fibrosis, Langerhans cell histiocytosis, pulmonary fibrosis, lung cancer) and carries higher morbidity.

Tension pneumothorax — a clinical diagnosis — occurs when a one-way valve mechanism allows progressive air accumulation with mediastinal shift, impaired venous return, and hemodynamic collapse. It requires immediate needle decompression followed by tube thoracostomy regardless of imaging confirmation.

Diagnosis is confirmed by chest radiograph (visible visceral pleural line without lung markings beyond), CT (gold standard for small pneumothorax and bleb detection), or lung ultrasound (absent lung sliding, lung point sign).

Symptoms

Sudden onset unilateral pleuritic chest pain, often sharp and localized
Acute dyspnea, varying with pneumothorax size and underlying lung reserve
Tachypnea, tachycardia, decreased oxygen saturation
Decreased or absent breath sounds, hyperresonance on percussion over affected hemithorax
Tension pneumothorax: hypotension, jugular venous distention, tracheal deviation, severe respiratory distress
Subcutaneous emphysema, crepitus around neck/chest (in some cases)

Risk Factors

Tall, thin body habitus, male sex (PSP)
Cigarette smoking — strongly increases PSP risk
Underlying lung disease: COPD/emphysema, cystic fibrosis, asthma, interstitial lung disease
Recent pulmonary infection, particularly pneumocystis or tuberculosis
Connective tissue disorders: Marfan syndrome, Ehlers-Danlos syndrome
Procedures: central venous catheterization, thoracentesis, transbronchial biopsy, mechanical ventilation barotrauma

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden onset of pleuritic chest pain and dyspnea warrants immediate medical evaluation, particularly in patients with underlying lung disease.
  • Severe respiratory distress, hypotension, or rapid deterioration requires emergency department evaluation and consideration of tension pneumothorax.
  • Known pneumothorax patients with recurrent symptoms, hemoptysis, or subcutaneous emphysema need urgent reassessment for enlarging pneumothorax or complications.

Treatment Methods

01
Small primary spontaneous pneumothorax (<2 cm apex-to-cupola distance, asymptomatic): observation with supplemental oxygen and outpatient follow-up.
02
Symptomatic or large pneumothorax: needle aspiration or small-bore chest tube (pigtail catheter or 14-16 Fr tube) with water-seal drainage.
03
Tension pneumothorax: immediate needle decompression (14-gauge needle in 2nd intercostal space midclavicular line or 5th intercostal anterior axillary line) followed by tube thoracostomy.
04
Persistent air leak (>5 days): surgical intervention with VATS bullectomy and pleurodesis (mechanical abrasion, talc, or chemical).
05
Recurrence prevention: smoking cessation, pleurodesis for recurrent PSP or any SSP, genetic counseling for familial or connective tissue disorders.
06
Avoidance of activities with pressure changes (scuba diving indefinitely; air travel restricted per guidelines until resolved).

Which Department to Visit?

You can visit our Göğüs Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göğüs Hastalıkları Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Related Health Topics

Other articles from the same department you may want to explore.

Asthma

Göğüs Hastalıkları

Asthma is characterized by wheezing, coughing and shortness of breath attacks; with proper treatment it can be kept under control.

COPD (Chronic Obstructive Pulmonary Disease)

Göğüs Hastalıkları

COPD is an irreversible lung disease characterized by shortness of breath and chronic cough; quitting smoking slows its progression.

Pneumonia

Göğüs Hastalıkları

Pneumonia presents with high fever, cough and shortness of breath; the vast majority recover with appropriate antibiotic treatment.

Tuberculosis (TB)

Göğüs Hastalıkları

Tuberculosis presents with weeks-to-months of cough, fever, and night sweats; early diagnosis and treatment lead to full recovery.

Pleural Effusion

Göğüs Hastalıkları

Pleural effusion is the accumulation of excess fluid in the pleural space, resulting from imbalances in fluid production and removal, and represents a manifestation of diverse cardiopulmonary, infectious, and malignant disorders.

Bronchitis (Acute and Chronic)

Göğüs Hastalıkları

Acute bronchitis is mostly viral and resolves spontaneously, while chronic bronchitis is a smoking-related component of COPD.

Bronchiectasis

Göğüs Hastalıkları

Bronchiectasis is a chronic respiratory disease characterized by permanent, abnormal dilation of bronchi with associated destruction of muscular and elastic components of airway walls, resulting in impaired mucociliary clearance and recurrent infection.

Pulmonary Embolism

Göğüs Hastalıkları

Pulmonary embolism presents with sudden shortness of breath and chest pain; immediate diagnosis and treatment are life-saving.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.