Spontaneous pneumothorax and the difference between pneumothorax.

Written by Han Shun Li
Pulmonology
Updated on September 11, 2024
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Simply put, spontaneous pneumothorax is a type of pneumothorax. In the classification of pneumothorax, besides spontaneous pneumothorax, there are also traumatic pneumothorax and iatrogenic pneumothorax. Traumatic pneumothorax is caused by direct or indirect injury to the chest wall, while iatrogenic pneumothorax occurs during medical diagnosis and treatment. Spontaneous pneumothorax often involves underlying lung diseases, such as emphysema, lung bullae, tuberculosis, lung cancer, and pneumoconiosis. It can also occur in healthy individuals without obvious lung abnormalities, typically seen in tall, thin males of young to middle age.

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Pneumothorax tracheal shift to which side?

When a patient suffers a pneumothorax, the trachea is displaced to the opposite side, and the heart is also shifted to the opposite side. In cases of left-sided pneumothorax, the heart's dullness boundary and the upper boundary of the liver during right-sided pneumothorax are both undetectable. There can be manifestations of subcutaneous emphysema in the neck, chest, and even the head and abdomen. The patient may exhibit diminished respiratory movements and a significant reduction or absence of breath sounds. When a small amount of air accumulates in the pleural cavity, weakened breath sounds on the affected side may be the only suspicious sign.

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Can pneumothorax be inherited?

In fact, medicine has found that most diseases, other than traumatic ones caused by injuries or car accidents, are related to genes or heredity. For instance, diseases like diabetes and hypertension clearly have a familial hereditary history. Pneumothorax is no exception, as it also tends to cluster in certain families, or has a higher tendency than in normal families. Therefore, pneumothorax does possess a certain hereditary nature, particularly in families prone to connective tissue disorders such as Marfan Syndrome. Additionally, pneumothorax often occurs in families with mutations in the human leukocyte antigen, and in those with conditions such as homocystinuria or antitrypsin deficiency, where pneumothorax is more prevalent. Of course, there are also conditions like Marfan Syndrome and Birt-Hogg-Dube (BHD) Syndrome in these families, which also tend to develop renal cysts, renal tumors, and skin fibrofolliculomas. Thus, the more frequent occurrence of pneumothorax in these families demonstrates that pneumothorax is genetically related and has a certain degree of heredity.

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Can pneumothorax recover by itself?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural space. Patients often display symptoms such as coughing, chest pain, chest tightness, and shortness of breath. A lung radiograph can confirm the presence of a pneumothorax. Whether a patient with pneumothorax can recover on their own depends on the size of the pneumothorax. If it is a large pneumothorax, especially a communicative or tension pneumothorax, self-recovery is not possible, and treatment generally involves pleural puncture or pleural drainage tube placement. However, if the amount of air in the pneumothorax is small and the patient does not exhibit severe symptoms, then it is possible for the condition to resolve itself with bed rest.

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What are the main signs of pneumothorax?

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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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.