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pneumothorax occurring without iatrogenic or other trauma; primary spontaneous pneumothorax generally occurs in young people with apical blebs but otherwise normal lungs; secondary spontaneous pneumothorax occurs in people with underlying lung disease, most commonly chronic obstructive pulmonary disease and, less often, interstitial lung disease, pneumonia, lung abscess, and lung tumors.
Etymology: L, sponte, free will; Gk, pneuma, air, thorax, chest
the presence of air or gas in the pleural space as a result of a rupture of the lung parenchyma and visceral pleura with no demonstrable cause.
spontaneous pneumothoraxEmergency medicine A condition affecting ± 17,000/yr–US, which may be idiopathic or 2º to underlying pulmonary disease–eg, COPD, most commonly occurring in previously healthy tall, thin ♂, age 20-40, 2º to rupture of subpleural blebs At-risk Smokers, family Hx of SP, asthma, emphysema, pneumothorax, rapid ascent to high altitude, histiocytosis.
Clinical Abrupt chest pain, with SOB proportionate to the size of the pneumothorax; tension pneumothorax, while rare, may compromise the circulation by a ball-valve mechanism Treatment Suction followed by water seal drainage Prognosis 30% recur on the same side, a tendency that may be ↓ by intrapleural tetracycline; 10% occur de novo on the opposite side
spon·ta·ne·ous pneu·mo·thor·ax(spon-tā'nē-ŭs nū'mō-thōr'aks)
Air or gas in the pleural cavity occurring secondary to parenchymal lung disease, usually from an emphysematous bulla that ruptures or occasionally from a lung abscess.
spontaneous pneumothoraxSudden and unexpected incursion of air into the space between the two layers of the PLEURA so that the underlying lung collapses. The usual cause is rupture of a congenital bleb on the inner pleural layer so that air passes from the lung. In most cases the leak seals itself and the lung soon re-expands.
Air in the chest cavity that occurs because of disease or other naturally occurring cause. Air and blood together in this space is called a pneumohemothorax.
Mentioned in: Chest Drainage Therapy
entry of air into the pleural cavity in sufficient quantity to cause collapse of the lung and consequent respiratory embarrassment. If it is unilateral there is a mediastinal shift with displacement of the heart to the other side of the chest. Breath sounds are absent from the affected side.
air leaks from a discontinuity in the lung into the pleural cavity.
artifactual increased radiolucency of the thorax resembling free air in the pleural cavity.
may occur following intrathoracic surgery or in association with procedures which involve entry into the pleural cavity, such as thoracentesis or placement of a chest drain.
caused by an open wound in the chest wall.
due to an unknown cause.
a particularly dangerous form of pneumothorax that occurs when air escapes into the pleural cavity from a bronchus but cannot regain entry into the bronchus. As a result, continuously increasing air pressure in the pleural cavity causes progressive collapse of the lung tissue. If not relieved, it can lead to lung collapse and mediastinal shift.