How is the fluid in pneumothorax drained?

Written by Yuan Qing
Pulmonology
Updated on February 28, 2025
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Pneumothorax with effusion is mostly due to trauma or structural issues in the lungs themselves, leading to lung rupture, accompanied by intrathoracic hematomas, effusion, or pneumothorax. This condition is known as hydro-pneumothorax. Generally speaking, the treatment method depends on the severity of the hydro-pneumothorax. Usually, a mild case can be absorbed by the patient naturally. However, if the pneumothorax occupies more than 30% of the thoracic cavity, closed thoracic drainage should be implemented, along with the removal of pleural effusion for absorption to take place. Of course, the specific disease must be clearly identified, which might require repair, tumor resection, or anti-tuberculosis treatment to ultimately address the cause of the disease.

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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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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 Li Tao
Pulmonology
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Pneumothorax is what disease?

Pneumothorax refers to the condition where gas enters the pleural cavity. Normally, the pleural cavity is a sealed space formed by the visceral pleura covering the lung surface and the parietal pleura on the chest wall. When gas enters the pleural cavity due to some reason, causing a state of gas accumulation, it is called pneumothorax. The causes of pneumothorax can be diseases of the lungs themselves or gas produced after the lungs and chest wall are injured by external forces. Typically, the condition occurs when the pleura near the lung surface ruptures, allowing gas to enter the pleural cavity, which is referred to as pneumothorax.

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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 Hao Ze Rui
Pulmonology
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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.