Spontaneous Pneumothorax | White Plains Hospital

Spontaneous Pneumothorax

A spontaneous pneumothorax is the collapse or partial collapse of a lung in an individual. This collapse occurs when air gets around the lungs causing it to be pushed down.

Risk Factors

  • Spontaneous pneumothoracies are frequently seen in young healthy individuals from their teens through 40-50 years of age.
  • Spontaneous pneumothorax occurs more commonly in males than females.
  • Spontaneous pneumothorax is seen most often in healthy individuals who are tall and lean with a low body weight.
  • Additional risk factors include smoking, Marfans Syndrome, thoracic endometriosis, a family history, and homocystinuria.

Symptoms

  • Usually sudden in onset
  • Chest pain
  • Shortness of breath
  • Pain when taking a deep breath
  • Sensation of inability to catch one’s breath
  • Frequently occurs at rest with no obvious precipitating factor
  • Occasionally precipitated by vigorous coughing

Diagnostic Tests

  • Diagnosis frequently made by listening to chest
  • Diagnosis confirmed with chest x-ray
  • Occasionally a CT Scan of the chest will be performed to look for a bubble known as a bleb or bullae

This a CT scan showing evidence of a right sided- pneumothorax.
This is a CT scan showing evidence of a right sided pneumothorax.

Treatment Options

  • Depending on extent and frequency of the collapse of the lung, treatment options could include:
    • Observation
    • Aspiration of air
    • Insertion of tube or catheter into the chest
    • Minimally Invasive Thoracic Surgery

Treatment Considerations

  • Patients whose lung collapse once and are treated by either observation or insertion of a chest tube, have a 15%-20% chance of having the pneumothorax recur.
  • The more often the pneumothorax recurs, the more likely it is to continue to recur.
  • Our team of thoracic surgeons will usually consider surgical intervention upon the occurrence of a second episode although occasionally surgery may be recommended earlier, if, for example, it is difficult to reexpand the lung with only a tube in the chest or if the patient is planning on being in a situation where medical care would not be readily and easily accessible.
  • Surgery, when indicated, will almost always be performed in a minimally invasive fashion using state of the art video-assisted thoracic surgery (VATS).
    • VATS allows us to visualize the entire surface of the lung and the cavity it lies in. If there is a bleb or bullae on the lung we can remove it. Our goal is to treat you while preserving as much lung as possible. Therefore, we will do a resection of the lung know as a wedge resection. We will also simulate scaring of the lung to the chest wall to minimize the chance that your lung can ever collapse again. Several surgical procedures (pleurectomy, mechanical or chemical pleurodesis) can be used to accomplish this.

At White Plains Hospital we have been performing Minimally Invasive Thoracic Surgery for almost 20 years and have a fully staffed Thoracic Surgery Service that includes board-certified thoracic surgeons, anesthesiologists, pulmonologist, and critical care intensivists. We also have a staff of highly trained nurses, respiratory therapists, nutritionists, physical therapists, case managers and social workers that work in-sync with your surgeon to provide great care for you when you are recovering from your surgery.