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.”
3
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
4
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 .
5
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
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
8
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
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.
12
13. The characteristics of
pneumothorax
Pleural line
No lung markings in
pneumothorax
13
14. A further use of CT is in the identification of
underlying lung lesions
14
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
15