What are the main signs of pneumothorax?

Written by Hao Ze Rui
Pulmonology
Updated on August 31, 2024
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If it is a small amount of pneumothorax, the physical signs are generally not obvious, especially when patients with emphysema develop pneumothorax, it is difficult to detect any signs. However, when a larger amount of pneumothorax occurs, inspection will reveal that the affected side of the chest is bulging and respiratory movements are reduced. Upon palpation, the trachea usually shifts towards the healthy side, tactile fremitus on the affected side is reduced, percussion results in hyperresonance or tympany, and auscultation shows reduced breath sounds, which can disappear in severe cases.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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How to check for hemothorax and pneumothorax?

Actually, the examination methods for hemothorax and pneumothorax are quite simple. From their definitions, we know that hemothorax means the abnormal presence of blood in the pleural cavity, and pneumothorax means the presence of gas in the pleural cavity where it shouldn't be. Therefore, the simplest examination is an X-ray, a standard frontal and lateral chest X-ray, which usually costs about 52 yuan, can detect whether a patient has pneumothorax. As for hemothorax, of course, it involves the use of a syringe. After injecting some lidocaine local anesthesia into the patient, if blood is withdrawn from the pleural cavity, then it indicates a hemothorax. Thus, the first step in examining for hemothorax and pneumothorax is to perform an X-ray to check for the presence of gas. If gas is detected, then it is pneumothorax. If liquid is found, a syringe under ultrasound guidance can be used to withdraw it. If the withdrawal yields fluid, it indicates pleural effusion; if blood is drawn, then it indicates hemothorax.

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Written by Han Shun Li
Pulmonology
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What position should be taken for pneumothorax?

Pneumothorax occurs when the pleura ruptures and gas enters the pleural cavity, often compressing the lung tissue. Patients may experience symptoms such as chest pain, chest tightness, and coughing. The choice of lying position for patients with pneumothorax depends on the severity of the pneumothorax and the degree of chest tightness. If the pneumothorax is mild and the symptoms are not obvious, the patient can lie flat. If there is significant chest tightness, a semi-recumbent position may be adopted. If the chest tightness is severe and the patient has significant difficulty breathing, they often assume a sitting position, frequently struggling to breathe, sweating profusely, and may even experience respiratory failure, requiring immediate attention.

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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 Han Shun Li
Pulmonology
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Can pneumothorax heal by itself?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural cavity, and it is relatively common clinically. Can pneumothorax be cured after it occurs? It depends on the specific circumstances. If it is a closed pneumothorax with a small amount of air accumulation, conservative treatments like rest and oxygen therapy can allow for self-healing of the pneumothorax. However, in most cases, the accumulation of air is generally significant, and often it is a tension pneumothorax. In these instances, treatments generally involve pleural cavity puncture, or closed pleural drainage to drain the air, making it difficult to heal spontaneously and requiring medical treatment. Moreover, some patients may not recover fully despite aggressive treatment and may require surgical intervention.

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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.