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What Causes Spontaneous Pneumothorax?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 15 December 2019
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Spontaneous pneumothorax, where a lung collapses because of air in the chest cavity, can be caused by rupture of an air filled sac in the lungs in individuals at high risk of developing such sacs, and it may also be the result of an underlying lung disease. This condition differs from traumatic pneumothorax, caused by trauma to the lung, and tension pneumothorax, where pressurized air causes a lung to collapse. Treatment involves evacuating the air or gas in the chest cavity so the lung can be reinflated, allowing the patient to breathe normally.

In primary spontaneous pneumothorax, a patient develops a collapsed lung because an air filled sac like a bleb or bulla inside the lung ruptures. This tends to be more common in tall, slender men, and there appears to be a genetic component putting some people at higher risk. People with a family history of pneumothorax or genetic conditions associated with it may be more likely to experience it themselves.

Secondary spontaneous pneumothorax involves a lung collapse caused by underlying disease. Tuberculosis, cystic fibrosis, pneumonia, asthma, and chronic obstructive pulmonary disease are all potential culprits. Some of these conditions cause gas bubbles like bullae to form. The patient will notice extreme difficulty breathing as a result of the collapsed lung and can experience discomfort on the side of the chest involved. The onset is usually rapid, and may be accompanied with an increase in other symptoms as well.

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Patients with underlying pulmonary disease may be advised to be observant for the signs of spontaneous pneumothorax, as it is a known risk. While in treatment for such conditions, changes in breath sounds need to be evaluated to see if something is happening inside the chest. Intervening early in the development of a collapsed lung and other complications of pulmonary disease can provide doctors with more treatment options.

Medical imaging studies can confirm a spontaneous pneumothorax, and the condition is also usually evident from clinical signs exhibited by the patient. A very small spontaneous pneumothorax may be left alone to see if it resolves, as long as the patient is not experiencing distress. For larger collapses, immediate relief involves insertion of a tube to allow the air in the chest to vent. The patient will be evaluated to see if an air leak is present still, in which case more treatments may be needed to prevent the lung from collapsing again.

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