Introduction:
A collapsed lung is medically known as pneumothorax. Lungs collapse when air fills or leaks in between the spaces of the lungs and the chest wall. A pneumothorax can cause a full lung collapse or only a part of the lung. An abnormal condition known as spontaneous pneumothorax involves the accumulation of gas in the pleural space between the lungs and the chest, resulting in the lung collapsing suddenly without any trauma. The patient may experience chest pain and difficulty breathing at times. It calls for immediate medical attention.
What Is Primary Spontaneous Pneumothorax?
Spontaneous pneumothorax is an accumulation of air because it does not occur in the presence of lung disease like emphysema, this type of pneumothorax is referred to as primary. Spontaneous indicates that the pneumothorax was not brought on by an injury like a broken rib. The formation of small air sacs (blebs) in the lung tissue that ruptures and allows air to leak into the pleural space is probably the cause of primary spontaneous pneumothorax. The lung can collapse as a result of pressure caused by air in the pleural space. Shortness of breath and chest pain in the collapsed lung may accompany this condition.
What Are the Causes of Spontaneous Pneumothorax?
There are certain factors that are responsible for spontaneous pneumothorax. Some of these are :
-
Trauma: Any lung or chest wall injury may result in pneumothorax. Like accidents, falls, and due to medical negligence like needle insertion into the chest.
-
Lung Diseases: Diseases like pneumonia and chronic obstructive pulmonary disease (COPD) damage the lung tissue making the lungs collapse.
-
Blebs: Blebs are small subpleural thin-walled air-containing spaces. When these bursts, they may let the air leak into spaces surrounding the lungs.
-
Medical Conditions: Tuberculosis, coronavirus, emphysema, etc.
-
Lifestyle: Smoking, drugs, deep sea diving, etc.
What Are the Symptoms of Spontaneous Pneumothorax?
Some of the signs and symptoms of pneumothorax are fatigue, shortness of breath, skin turning blue in color, rapid heart rate and breathing rates, chest pain, and nasal flaring. If any of these signs are present, medical attention is required.
What Are the Different Types of Spontaneous Pneumothorax?
There are two types of spontaneous pneumothorax:
-
Primary: It can occur in any person with unknown lung problems. The causes are unclear; however, several risk factors that contribute are smoking, male sex, and history of pneumothorax.
-
Secondary: It usually occurs in individuals with any kind of lung problem. Underlying diseases such as COPD, asthma, and cystic fibrosis are responsible for this.
What Is the Mechanism of Action of Spontaneous Pneumothorax?
The main principle revolves around gas leaking into the pleural space. Spontaneous pneumothorax is a multifactorial process. Any increase in alveolar pressure exceeding the pulmonary interstitial pressure may result in alveolar rupture and air leakage. Though, the exact mechanism is not understood entirely. The thoracic cavity is filled to the brim with air. Pneumothorax occurs when air enters through damage to the lung or the chest wall or occasionally when gas is produced by microorganisms in the pleural space.
What Is the Diagnosis of Spontaneous Pneumothorax?
To make an accurate diagnosis, the medical team evaluates symptoms and performs a physical examination, such as:
-
History: Full medical history is taken, and assesses the symptoms the patient is experiencing. Questions regarding when the symptoms started, the severity of the pain, or shortness of breath.
-
Physical Examination: Decreased or no breath sounds on the affected side is observed and monitored.
-
Chest X-ray: The radiologic chest X-ray will show a pneumothorax clearly if it is present.
-
Ultrasound: This shows diagnostic potential in the case of pneumothorax.
What Are the Complications of Spontaneous Pneumothorax?
The majority of collapsed cases heal well and do not result in complications. However, depending on the size and severity of the pneumothorax, complications such as heart failure, pulmonary swelling, infections, and even death may occur in some instances.
What Are the Treatments for Spontaneous Pneumothorax?
The duration, severity of symptoms, and size of the pneumothorax are the factors that decide the mode and action of treatment.
-
Patients with minimal and resolving symptoms receive a chest X-ray after one day to decide on treatment. A small pneumothorax may only require brief hospitalization for oxygen supplementation and observation.
-
Patients with a large pneumothorax need treatment within a short time of the onset and may have severe symptoms requiring the placement of a chest tube between the ribs. The placement of a chest tube typically enables the lung to rapidly and fully re-expanded. It is possible to leave the chest tube in place for several days.
-
Patients with recurrent spontaneous pneumothorax and regular air leaks from the chest tube lasting longer than five days may require surgical intervention.
-
The final solution is known as pleurodesis. The lung is attached to the chest wall, and the pleural space is permanently cleared during this procedure.
-
For patients with large pneumothorax and heavy breathlessness, aspiration is recommended to reduce the size. In this procedure, a local anesthetic is given, and a needle is inserted and connected to a three-way tap.
What Is the Aftercare Required for the Patients?
Once the patient has suffered from pneumothorax, the desired treatment has been provided. After the treatment, there is a need to take care at home to prevent a recurrence.
-
Because their lungs are not in good enough shape after a spontaneous pneumothorax, smokers should avoid work for up to a week.
-
Recovery time for patients who have undergone pleurodesis can range from two to three weeks.
-
Air travel has to be avoided for up to seven days.
-
Underwater diving is regarded as unsafe after pneumothorax.
Conclusion :
Spontaneous pneumothorax is a sudden attack and needs medical treatment as soon as possible. The treatment depends on certain factors like type, severity, etc. The majority of simple and small pneumothorax cases can be managed conservatively with regular follow-up. The risk factors associated with the disease are to be taken care of to prevent this. Immediate treatment is helpful in faster recovery and prevention of risk factors.
