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
1min 15sec home-news-image

The difference between tension pneumothorax and open pneumothorax.

The main difference between a tension pneumothorax and an open pneumothorax lies in the relative pressures of the pleural cavity compared to the atmospheric pressure. An open pneumothorax occurs when the pleural cavity is in an open state due to some reason. During inhalation, gas can enter the pleural cavity, and during exhalation, the gas can be expelled through this opening or another opening, resulting in pleural cavity pressure that is roughly equal to the atmospheric pressure. In a tension pneumothorax, due to some reason, a one-way valve is formed. The gas enters the pleural cavity easily but encounters resistance during expulsion, causing the pressure in the patient's pleural cavity to increase progressively. The gas can only enter the pleural cavity and cannot be effectively expelled. Therefore, the main difference between a tension pneumothorax and an open pneumothorax is the level of pleural cavity pressure compared to atmospheric pressure; in a tension pneumothorax, the pressure in the pleural cavity is significantly higher than the atmospheric pressure, while in an open pneumothorax, the pressures are roughly equal.

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Written by Han Shun Li
Pulmonology
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Are the symptoms of pneumothorax severe?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural cavity. The severity of symptoms after suffering from pneumothorax can vary, with common symptoms including coughing, chest pain, chest tightness, and difficulty breathing. The severity of symptoms largely depends on the amount of air in the pleural space. If the amount of air is small, symptoms might not be noticeable. However, with a larger amount of air, difficulty breathing can be quite severe. In cases of tension pneumothorax, the symptoms can be extremely severe and may even lead to respiratory and circulatory failure in a short period. Patients often experience significant chest tightness, restlessness, dry skin, heavy sweating, and may even lose consciousness. Immediate treatment is necessary, as there could be a risk to life.

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Written by Li Jie
Orthopedics
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How to treat rib fracture and pneumothorax?

After a rib fracture, if a pneumothorax occurs, it is a very serious complication. There are three types of pneumothorax: closed pneumothorax, open pneumothorax, and tension pneumothorax. The simplest is the closed pneumothorax. If the area of lung compression in a closed pneumothorax is less than 30%, there is a hope for self-healing, and generally no special treatment is needed; if the lung compression exceeds 30%, it might be necessary to place a closed thoracic drainage tube to drain the air accumulating in the chest cavity, which may need to stay in the chest cavity for about a week. This is the treatment for a closed pneumothorax. If it is an open pneumothorax, it means there is an open wound on the chest. The treatment principle is to convert the open pneumothorax to a closed pneumothorax, which means sealing the wound, turning it into a closed pneumothorax, and then taking x-rays to assess the degree of lung compression. If the compression is significant, closed thoracic drainage is still necessary; if the compression is less severe, observation can continue. For a tension pneumothorax, it is the most severe type of pneumothorax and must be taken very seriously. Emergency placement of a closed thoracic drainage is recommended and must be handled promptly, as it could pose a life-threatening risk. In summary, once a pneumothorax occurs following rib fractures, it must be taken seriously. It is necessary to go to the hospital's thoracic surgery or orthopedic department for formal and timely treatment to prevent potentially severe consequences.

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Written by Xia Bao Jun
Pulmonology
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Pneumothorax is caused by what?

Pneumothorax is caused by the entry of air into the pleural cavity, leading to a series of changes. Pneumothorax can be divided into spontaneous and traumatic pneumothorax. Spontaneous pneumothorax occurs without trauma or other causes, while traumatic pneumothorax is caused by direct or indirect trauma to the pleura. Spontaneous pneumothorax can be further categorized into primary and secondary pneumothorax. Patients with primary spontaneous pneumothorax do not have underlying lung disease, whereas secondary pneumothorax is a complication of lung disease, commonly seen in chronic obstructive pulmonary disease. Traumatic pneumothorax includes iatrogenic pneumothorax, which occurs during diagnostic and therapeutic procedures.

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Written by Han Shun Li
Pulmonology
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Pneumothorax pleurodesis: what are the advantages and disadvantages?

Pleurodesis for pneumothorax involves injecting a sclerosant into the pleural cavity to induce a sterile inflammation, causing adhesion of the parietal and visceral pleurae, thereby eliminating the pleural space. This can be used to treat pneumothorax. The benefits include a high success rate, simple operation, and low recurrence rate. The downside is that there can be adverse reactions, the most common being chest pain and fever; severe cases may cause acute respiratory distress syndrome. Therefore, extra care is needed during the pleurodesis procedure.