Medical questions & health advice by licensed doctors
"Is pneumothorax life threatening?"
My brother in law has it after a bike accident. What do they have to do for him?
A pneumothorax occurs when there is air or gas in the lung pleural cavity compressing some of the lung tissue. There are varying degrees of a pneumothorax (PTX) as some are mild and require only monitoring and others can be life threatening. If it is mild, he may be monitored by his primary care physician or a pulmonologist (lung specialist), but if it is more severe, he may be admitted to the hospital. There are various causes for a pneumothorax, including trauma and spontaneous development. A life threatening condition can occur when a tension pneumothorax develops and displaces a patient's mediastinal structures (including heart and trachea). This can cause signficant respiratory and cardiovascular compromise and requires emergent evaluation and treatment. There is no consensus on the treatment of a pneumothorax and will largely depend on a patient's medical history, cause for the PTX, and degree of lung collapse and cardiovascular involvement. Treatment options include observation, supplemental oxygen delivery, needle aspiration, chest tube drainage, vacuum assisted thoracostomy (VATS), and an open surgical procedure. These treatments have been listed in order of increasing invasiveness. If your brother in law is stable with only a small PTX seen on chest xray and no clinical manifestations, his physician will likely start with basic treatment with observation and possible supplemental oxygen. His physician will continue to follow his respiratory and cardiovascular status and determine if further interventions are required. A pneumothorax can be a scary diagnosis but your primary care doctor can help discuss the diagnosis and decide if a pulmonology consult or hospital admission are required. Please schedule an appointment wit him or her.
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