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    Dhiya Rahadian
    Pneumothorax is the presence of air in the pleural cavity between the lungs and chest wall. It can impair breathing and circulation. Air enters through the chest wall from trauma or through the lung tissue. Symptoms range from none to life-threatening and depend on the type and size of pneumothorax. A physical exam may reveal shortness of breath, decreased or absent breath sounds, and a shift of the heart away from the affected side. Chest x-rays are required for diagnosis.

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    Pneumothorax is the presence of air in the pleural cavity between the lungs and chest wall. It can impair breathing and circulation. Air enters through the chest wall from trauma or through the lung tissue. Symptoms range from none to life-threatening and depend on the type and size of pneumothorax. A physical exam may reveal shortness of breath, decreased or absent breath sounds, and a shift of the heart away from the affected side. Chest x-rays are required for diagnosis.

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    pneumothorax

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    Pneumothorax is the presence of air in the pleural cavity between the lungs and chest wall. It can impair breathing and circulation. Air enters through the chest wall from trauma or through the lung tissue. Symptoms range from none to life-threatening and depend on the type and size of pneumothorax. A physical exam may reveal shortness of breath, decreased or absent breath sounds, and a shift of the heart away from the affected side. Chest x-rays are required for diagnosis.

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    41 views2 pages

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    Uploaded by

    Dhiya Rahadian
    Pneumothorax is the presence of air in the pleural cavity between the lungs and chest wall. It can impair breathing and circulation. Air enters through the chest wall from trauma or through the lung tissue. Symptoms range from none to life-threatening and depend on the type and size of pneumothorax. A physical exam may reveal shortness of breath, decreased or absent breath sounds, and a shift of the heart away from the affected side. Chest x-rays are required for diagnosis.

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    Practice Essentials

    Pneumothorax is defined as the presence of air or gas in the pleural


    cavity (ie, the potential space between the visceral and parietal pleura of
    the lung), which can impair oxygenation and/or ventilation. The clinical
    results are dependent on the degree of collapse of the lung on the
    affected side. If the pneumothorax is significant, it can cause a shift of the
    mediastinum and compromise hemodynamic stability. Air can enter the
    intrapleural space through a communication from the chest wall (ie,
    trauma) or through the lung parenchyma across the visceral pleura. See
    the image below.

    Radiograph of a patient with a


    complete right-sided pneumothorax due to a stab wound.
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    Signs and symptoms
    The presentation of patients with pneumothorax varies depending on the
    following types of pneumothorax and ranges from completely
    asymptomatic to life-threatening respiratory distress:
     Spontaneous pneumothorax: No clinical signs or symptoms in
    primary spontaneous pneumothorax until a bleb ruptures and causes
    pneumothorax; typically, the result is acute onset of chest pain and
    shortness of breath, particularly with secondary spontaneous
    pneumothoraces
     Iatrogenic pneumothorax: Symptoms similar to those of spontaneous
    pneumothorax, depending on patient’s age, presence of underlying
    lung disease, and extent of pneumothorax
     Tension pneumothorax: Hypotension, hypoxia, chest pain, dyspnea
     Catamenial pneumothorax: Women aged 30-40 years with onset of
    symptoms within 48 hours of menstruation, right-sided
    pneumothorax, and recurrence
     Pneumomediastinum: Must be differentiated from spontaneous
    pneumothorax; patients may or may not have symptoms of chest
    pain, persistent cough, sore throat, dysphagia, shortness of breath,
    or nausea/vomiting
    See Clinical Presentation for more detail.
    Diagnosis
    History and physical examination remain the keys to making the
    diagnosis of pneumothorax. Examination of patients with this condition
    may reveal diaphoresis and cyanosis (in the case of tension
    pneumothorax). Affected patients may also reveal altered mental status
    changes, including decreased alertness and/or consciousness (a rare
    finding).
    Findings on lung auscultation vary depending on the extent of the
    pneumothorax. Respiratory findings may include the following:
     Respiratory distress (considered a universal finding) or respiratory
    arrest
     Tachypnea (or bradypnea as a preterminal event)
     Asymmetric lung expansion: Mediastinal and tracheal shift to
    contralateral side (large tension pneumothorax)
     Distant or absent breath sounds: Unilaterally decreased/absent lung
    sounds common, but decreased air entry may be absent even in
    advanced state of pneumothorax
     Minimal lung sounds transmitted from unaffected hemithorax with
    auscultation at midaxillary line
     Hyperresonance on percussion: Rare finding; may be absent even in
    an advanced state
     Decreased tactile fremitus
     Adventitious lung sounds: Ipsilateral crackles, wheezes

    Sumber : eedicine.medscape.com

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