What department should I go to for pneumothorax?

Written by Wang Xiang Yu
Pulmonology
Updated on September 05, 2024
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What department is pneumothorax treated in? For pneumothorax, we commonly see patients first in the emergency department, as the onset of pneumothorax is generally very sudden and the condition can be quite severe. The patient may suddenly experience difficulty breathing, and in most cases, this breathing difficulty is severe. Therefore, patients typically start by seeing the emergency internal medicine department. The doctors there will assess the patient’s condition and will consult with thoracic and cardiovascular surgery and respiratory medicine. If a closed thoracic drainage tube is needed, our surgeons will immediately perform the drainage. If the patient can be treated conservatively, they are usually then transferred to either respiratory medicine or thoracic and cardiovascular surgery for further treatment.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pneumothorax recurrence symptoms

We know that normally there is no air in the pleural cavity, only a small amount of fluid or lubricant exists. However, in certain people, such as those who often smoke, tall and thin young people, and patients with chronic bronchitis, the alveoli in their lungs tend to be more fragile and can easily rupture. People experiencing a pneumothorax for the first time might feel this during certain situations like after a cold, coughing, sneezing, or playing sports, which can lead to a recurrence of the pneumothorax. Early symptoms of a recurrence, due to only a small amount of air compression, might not be very uncomfortable, just a slight sense of difficulty breathing. As the pneumothorax increases, symptoms like chest pain and difficulty breathing can develop. Therefore, the symptoms of a recurring pneumothorax are not identical each time, but there is a pattern; the severity can range from mild breathing difficulty to severe respiratory distress and chest pain.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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How many days does it take for a pneumothorax to heal?

The healing time for a patient with pneumothorax, or how many days it takes to heal, mainly depends on when the rupture on the lung heals. In younger patients who have good elasticity and strong healing capabilities, and whose nutrition keeps up, pneumothorax tends to heal relatively easily. Especially in younger patients experiencing pneumothorax for the first time, 70-80% may heal within two to three days because the gas escapes very quickly. Once the surface rupture on the lung heals, it can be cleared within a day, leading to healing. However, if the patient is older and also has conditions like tuberculosis or chronic bronchitis, the elasticity of the lungs is poorer, making healing difficult. Like a balloon without elasticity, if it gets a rupture, it may continue to expand, complicating the prediction of healing time. Regardless of age, whether the patient is young or old, if pneumothorax recurs a second time, it is advisable to seek aggressive treatment. Patients who have experienced pneumothorax twice are at more than a 70% to 80% risk of a third occurrence. This indicates a weak spot on the lung surface, similar to a wound on the hand. If a hand wound does not heal in a few days, it can be sutured. The same applies to lung surface wounds; as it is located inside the chest cavity, a thoracoscope is needed for suturing. Thus, in normal circumstances, pneumothorax could heal in a few days, but if repeatedly delayed, aggressive treatment might be necessary.

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Written by Xia Bao Jun
Pulmonology
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How is pneumothorax treated?

The treatment of pneumothorax aims to promote the reexpansion of the affected lung and reduce recurrence, while considering the possibility of eliminating the cause of the disease. Treatment measures include non-surgical and surgical treatments. Non-surgical measures include observation, thoracic puncture for air evacuation, closed thoracic drainage, and pleural fixation. Surgical treatments include thoracoscopic surgery and open chest surgery. Choices should be made based on the type and frequency of occurrence of the pneumothorax, the degree of compression, the state of the condition, and the presence of complications, etc. Most patients can be cured through non-surgical treatment, while only a minority, approximately 10%-20% of patients, require surgical treatment.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pneumothorax should be seen by which department?

If it is the patient's first pneumothorax occurrence and they are relatively young with no obvious lung bullae on the surface of their lungs, then seeing the emergency department should be sufficient to resolve the issue. Generally, if less than 20% of the lung is compressed, the patient can simply breathe oxygen at home or at a community hospital to gradually recover. However, if the patient is older and the degree of pneumothorax exceeds 20%, even reaching above 30%, it is advisable to insert a small tube between one and two millimeters into the pleural cavity to extract the air. At this point, it is recommended to consult thoracic surgery. After the air is released, a CT scan is also necessary to check for obvious lung bullae or small tears on the lung surface. If a small tear is found, it is best to use minimally invasive thoracoscopy to suture or seal the tear to prevent recurrence. Therefore, if possible, directly consider consulting thoracic surgery for pneumothorax; if thoracic surgery is not available, then consider seeing the emergency department.

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Written by Han Shun Li
Pulmonology
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Is pneumothorax the same as emphysema?

Pneumothorax and emphysema can both manifest symptoms such as chest tightness, difficulty breathing, and coughing. However, is pneumothorax the same as emphysema? Pneumothorax and emphysema are two different diseases. Simply put, pneumothorax is a pleural disease caused by a rupture of the pleura, while emphysema is a disease of the airways. When a lung is imaged for pneumothorax, the film shows lung compression. It is possible to see the external boundary of the compressed lung where pneumothorax is present, with no lung markings. In the case of emphysema, imaging shows that the thoracic cage is expanded, with widened intercostal spaces, and increased translucency in both lung lobes. Therefore, the differences between pneumothorax and emphysema are significant, and they are not the same disease.