Epidemiology

Etiology

Pathophysiology

• Spontaneous pneumothorax: rupture of blebs and bullae �?air moves into pleural space with increasing positive pressure �?ipsilateral lung is compressed and collapses
• Traumatic pneumothorax
  • Closed pneumothorax: air enters through a hole in the lung (e.g., following blunt trauma)
  • Open pneumothorax: air enters through a lesion in the chest wall (e.g., following penetrating trauma)
    • Air enters the pleural space on inspiration and leaks to the exterior on expiration.
    • Air shifts between the lungs.
• Tension pneumothorax
  1. Disrupted visceral pleura, parietal pleura, or tracheobronchial tree
  2. One-way valve mechanism, in which air enters the pleural space on inspiration but cannot exit
  3. Progressive accumulation of air in the pleural space and increasing positive pressure within the chest
  4. Collapse of ipsilateral lung; compression of contralateral lung, trachea, heart, and superior vena cava; angulation of inferior vena cava
  5. Impaired respiratory function, reduced venous return to the heart
  6. Reduced cardiac output
  7. Hypoxia and hemodynamic instability

Clinical features

Diagnostics

Treatment