Definition of Pneumothorax
A pneumothorax is an abnormal collection of air between the visceral and parietal pleura.
Types
Pneumothorax can be Spontaneous or Traumatic.
Causes
Spontaneous pneumothorax
- Primary – Apical subpleural bullae, that rupture, usually in young adults.
- Secondary
– Emphysema/COPD (common)
– Asthma
– Eosinophilic granuloma
– Lymphangioleiomyomatosis
– Lung abscess
– Bronchogenic Ca
– Langerhan’s cell granulomatosis
– Marfan’s syndrome
– Pneumocystis jirovecii pneumonia
– Advanced fibrosis
Traumatic pneumothorax
– Rib fracture
– Penetrating injury
– Pleural aspiration
– High positive end-expiratory pressure (PEEP) or mechanical ventilation
– Esophageal rupture
What are the indications to insert a chest drain?
3 main indications to insert a chest drain are:
1. Respiratory compromise – significant breathlessness, hypoxemia.
2. Tension pneumothorax
3. Large pneumothorax – distance of >2 cm between the lung and parietal pleura
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