Spontaneous pneumothorax is a collection of air or gas in the space between the lungs and the chest that "collapses" the lung and prevents it from inflating completely.

See also: Pneumothorax

There are two types of spontaneous pneumothorax:

• Primary spontaneous pneumothorax
• Secondary spontaneous pneumothorax

Spontaneous means there is no traumatic injury to the chest or lung. Primary spontaneous pneumothorax occurs in people without lung disease. It occurs most often in tall, thin, young people.

Sometimes people have a family history of this problem. People who have had one spontaneous pneumothorax are at higher risk of the same thing (on the same side or the other side) occurring again.

Secondary spontaneous pneumothorax occurs in people who have underlying lung disease. The most common lung disease that causes spontaneous pneumothorax is chronic obstructive pulmonary disease (COPD).

Other lung diseases associated with spontaneous pneumothorax include:

• Asthma
• Cystic fibrosis
• Interstitial lung disease
• Lung cancer
• Pneumonia
• Tuberculosis

• Abnormal breathing movement
  • Restricting chest wall motion when breathing to protect against pain
  • Splinting -- bending over or holding the chest to protect against pain
• Cough
• Rapid respiratory rate
• Shortness of breath
• Sudden chest pain or chest tightness
  • Breathing or coughing makes pain worse
  • Chest pain may be dull, sharp, or stabbing

The doctor will use a stethoscope to listen to the lungs and breath sounds.

You also may have the following tests:

• Chest x-ray
• Arterial blood gases

The objective of treatment is to remove the air from around the lungs, allowing the lung to re-expand. Small lung collapses may get better without any treatment.

Aspiration (withdrawal) of air may re-expand the lung. Placing a chest tube between the ribs into the pleural space allows the removal of air when simple aspiration is not successful or if the pneumothorax is large.

Re-expansion of the lung may take several days with the chest tube left in place. Hospitalization is required to manage the chest tube. Some people may need surgery for repeated lung collapses.

A procedure called pleurodesis can help prevent air and fluid buildup around the lungs and prevent collapses.

Patients should stop smoking and avoid high altitudes, scuba diving, or flying in unpressurized aircraft to prevent pneumothorax from recurring.

Many patients with spontaneous pneumothorax have the same problem again later.

Call your health care provider if you develop severe shortness of breath.

Call your health care provider if you have had a spontaneous pneumothorax and you are experiencing the same or similar symptoms.

Stopping smoking will decrease the risk of developing severe lung disease that may lead to pneumothorax. Controlling lung diseases such as asthma may lower the risk of pneumothorax.

Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, et al. Management of spontaneous pneumothorax. Chest. February 2001;199:590-602.

Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000.

Marx J., Hockberger R, Walls R. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby; 2005.