Pneumothorax CT manifestations

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on January 19, 2025
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Pneumothorax CT manifestations, we know that there is a potential gap between the lungs and the chest wall in normal individuals, but normally, this gap or cavity is under negative pressure. This negative pressure ensures that the lungs are pressed tightly against the chest wall and the pleura, also containing a certain amount of lubricating fluid which allows for movement during inhalation without excessive friction causing pain. However, if due to some reason, such as a burst large or small pulmonary bullae, air enters this potential cavity or the pleural space, it is referred to as pneumothorax. Moreover, on a CT scan, it is distinctly visible that part of the chest cavity shows an area devoid of air-containing lung structures, indicating the absence of normal lung in this region. Normally on CT, a healthy lung appears like a sponge, so this phenomenon reveals sponge-like tissue, referred to as lung texture. But when air enters, the pressure from the air can compress the lung, causing it to collapse, similar to a deflating balloon. In addition, part of the CT imaging presents as dark areas around the periphery where lung textures are absent or cavities appear, referred to as pneumothorax.

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Written by Li Ying
Pulmonology
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How many days do you usually stay in the hospital for pneumothorax drainage?

This depends on whether the pneumothorax is a simple pneumothorax or is complicated by other diseases. If there are no other lung diseases present and it is just a simple pneumothorax, then typically, drainage by tube for 5 to 7 days can lead to a complete recovery and cure. However, if there are complications such as emphysema, pulmonary heart disease, pneumoconiosis, or lung infections, then it is necessary first to control the infections. During this time, the pneumothorax can easily become a communicating pneumothorax. If it lasts for more than 1 to 2 weeks, it may turn into a refractory pneumothorax. In the case of refractory pneumothorax, besides drainage, minimally invasive surgeries such as pleurodesis or pneumothorax occlusion procedures are required. These surgeries take time. Therefore, if a stubborn pneumothorax forms, especially when complications like emphysema are present, hospital stays often need to be 14 days or even longer.

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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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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.

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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 Han Shun Li
Pulmonology
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Can pneumothorax patients take a plane?

Pneumothorax is a relatively common clinical condition, usually caused by a rupture of the pleura, allowing air to enter the pleural cavity. Patients often experience symptoms such as chest pain, difficulty breathing, and coughing. So, can someone with pneumothorax fly on an airplane? Patients with pneumothorax are prohibited from flying because the high altitude may aggravate the condition, leading to serious consequences. Even after pneumothorax has healed, it is advised not to fly within a year, as flying may cause the pneumothorax to recur.