Pneumothorax should be seen by which department?

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on April 14, 2025
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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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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 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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Pneumothorax CT manifestations

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 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 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.