Treatments and drugs
By Mayo Clinic staffThe goal in treating a pneumothorax is to relieve the pressure on your lung, allowing it to re-expand, and to prevent recurrences. The best method for achieving this depends on the severity of the lung collapse and sometimes on your overall health.
Observation
If only a small portion of your lung is collapsed, your doctor may simply monitor your condition with a series of chest X-rays until the air is completely absorbed and your lung has re-expanded. This may require bed rest as any exertion may aggravate the collapse. Supplemental oxygen can speed the absorption process.
Needle or chest tube insertion
If a larger area of your lung has collapsed, it's likely that a needle or chest tube will be used to remove the air. The hollow needle or tube is inserted between the ribs into the air-filled space that is pressing on the collapsed lung. With the needle, a syringe is attached so the doctor can pull out the excess air — just like a syringe is used to pull blood from a vein. Chest tubes are often attached to a suction device that continuously removes air from the chest cavity and may be left in place for several hours to several days.
Surgery
If a chest tube doesn't resolve your problem, surgery may be necessary to close the air leak. In most cases, the surgery can be performed through small incisions, using a tiny fiberoptic camera and narrow, long-handled surgical tools. The surgeon will look for the leaking bleb and sew it closed. If no leaking bleb is visible, a substance like talc is blown in through the tube to irritate the tissues around the lung so that they'll stick together and seal any leaks. Rarely, the surgeon will have to make a larger incision between the ribs to get better access to multiple or larger air leaks.
- Light RW, et al. Pneumothorax, chylothorax, hemothorax and fibrothorax. In: Mason RJ, et al. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/das/book/body/192068760-2/0/1288/0.html. Accessed Jan. 26, 2011.
- Celli BR. Diseases of the diaphragm, chest wall, pleura and mediastinum: The pleura. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed Jan. 26, 2011.
- Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 31, 2011.
- Eckstein M, et al. Thoracic trauma: Pulmonary injuries. In: Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed Jan. 26, 2011.
- Legome E. General approach to blunt thoracic trauma in adults. http://www.uptodate.com/home/index.html. Accessed Jan. 26, 2011.
- Light RW. Secondary spontaneous pneumothorax in adults. http://www.uptodate.com/home/index.html. Accessed Jan. 26, 2011.
- Light RW. Primary spontaneous pneumothorax in adults. http://www.uptodate.com/home/index.html. Accessed Jan. 26, 2011.


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