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Definition of Pneumothorax:-

Literal meaning of term Pneumothorax is
Pneumothorax - Air in the chest

•Pneumothorax is the accumulation of air in the pleural cavity.

• It occurs when parietal or visceral pleura is exposed to positive atmosphere pressure.

•Normally, the pressure in the Pleural space is negative which is used to maintain negative pressure in the chest.

Types of Pneumothorax:-

Simple Pneumothorax:-

•It occurs when air enters the pleural space through visceral pleura, i.e. through rupture of bronchopleural fistula.
•It is associated with diffused interstitial lung disease and severe emphysema.

👉Traumatic Pneumothorax:-

•It occurs due to penetrating trauma to the Chest wall. In this case, air enters the pleural space through parietal pleura.
•It can occur with a rib fracture ( from protruding broken ribs) and a knife or gun shot wound.

👉Spontaneous Pneumothorax:-

•It is the spontaneous appearance of air in the pleural space.
•It usually occurs as a result of rupture of emphysematous Bullae or Blebs ( blister like defects in lung tissue in patient with underlying lung disease like emphysema) or rupture of visceral pleura, which allows air into the pleural space.

👉Open Pneumothorax:-

•In this case, air can enter and escape through opening in the pleural cavity.
• It occurs with a sucking chest wound, where the chest wound or opening is large enough to allow air to move in and out of the pleural cavity during ventilation.

👉Closed Pneumothorax:-

•In closed Pneumothorax, air collects in the pleural cavity, but is unable to escape.
• It usually occurs when air enters into pleural space from a tear or puncture in an internal respiratory structure, e.g. bronchus, bronchioles, alveoli, etc.

👉Tension Pneumothorax:-

•In tension Pneumothorax, air enters the pleural space with each inspiration, becomes trapped and is not expelled during expiration.
•As air accumulation in pleural space, tension and pressure build up in pleural space.
•This is a serious type of Pneumothorax.

Etiology and Risk factors of Pneumothorax:-

•Chest injury
•Ruptured air blisters
•Lungs disease
•Smoking
•Genetic
•After thoracentesis
•Previous Pneumothorax
•Machanical ventilation

Pathophysiology of Pneumothorax:-

Due to the etiological factor
👇
Air enters in pleural space
👇
Pneumothorax
👇
Pleuritic chest pain, tachypnea and Chest discomfort
👇
Lung collapse

Clinical manifestations of Pneumothorax:-

•Sharp Chest pain
•Shortness of breath
•Chest tightness
•Cyanosis
•Severe tachycardia
•Cough
•Fatigue
•Asymmetric Chest expansion
•Absent or diminished breath sound
•Restlessness
•Anxiety


Diagnostic evaluation of Pneumothorax:-

•History Taking
•Physical examination
•Chest X-ray
•Ultrasonography
•ABGs test
•CT-Scan

Medical management:-
•The medical management of pneumothorax does not involve specific medicines
•But focuses on supportive treatment. Analgesics, such as paracetamol or NSAIDs, can be used for relieving chest pain.
•If the patient has undergone surgery or chest tube insertion, antibiotics like ceftriaxone or amoxicillin clavulanate are administered to prevent secondary infections.

Surgical management:-
•Thoracentesis
•Chest tube drainage
•Pleurodesis
•Thoracotomy

Supportive care:-

•Oxygen therapy
•Deep breathing exercises
•Rest and sleep
•Positioning
•Diet
•Avoid irritants
•Change Life style

Complications:-

•Hemorrhage
•Empyema
•Arrhythmia
•Respiratory failure



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