Primary pneumothorax

Primary pneumothorax is pneumothorax that occurs spontaneously, that is, without a triggering factor, in an overall healthy lung. It is a condition that mostly affects young people, more often men than women.
The cause is often the spontaneous rupture of a small peripheral apical bubble. These bubbles are most often located at the apex (top) of the lung. Spontaneous pneumothorax occurs more often in smokers than in non-smokers.
This causes a very variable symptomatology ranging from a feeling of chest discomfort, through pain, to dyspnea (shortness of breath). The pneumothorax can be small, that is, only the top of the lung is detached from the wall, as it can be complete, meaning that the lung is completely collapsed (deflated).

Treatment

The initial treatment depends on the severity of the pneumothorax. When it is not very important, it is enough to make sure of its spontaneous and complete resolution which occurs in a few days, even one or two weeks. If it is more important, a drain will be placed in the pleural space, which can be done under local anesthesia at the patient’s bed. Most of the time, this action fixes the problem in a few days.
When a pneumothorax has occurred for the first time, there is about a one in five chance of recurrence. In a second episode (first recurrence), the risk of recurrence is about one in two. The risk is about four in five during the third episode (second recurrence). Therefore, surgical treatment is generally offered during the second episode (first recurrence). The operation, which is a pleurectomy, is relatively simple and consists of resecting the responsible bubble and making a gesture that “sticks” the lung to the wall – in general, the pleura is mechanically irritated by simple abrasion. This operation is most often done by thoracoscopy. The postoperative hospital stay is generally 2 to 3 days.
The cases where surgical treatment is offered during a first episode of pneumothorax are those where the drain does not allow the pneumothorax to be overcome after a few days and those where the occurrence of pneumothorax represents a particular danger for the patient. patient (aviation personnel and professional divers in particular). Indeed, if with each breath there is always a little more air which enters the pleural cavity and which it cannot leave, it gradually forms a pneumothorax under tension which compresses and deforms the large venous structures. inside the chest, preventing blood from returning to the heart. There is then a danger to the patient’s life if the pneumothorax is not drained immediately.

Secondary pneumothorax

Secondary pneumothorax has an identifiable cause.
It can be a disease or injury of the lung such as severe emphysema, lymphangioleiomyomatosis (a congenital disease affecting women which causes lung cysts to form) or a lung tumor.
However, trauma is the most common cause of secondary pneumothorax.
Finally, it sometimes happens that it is the doctor who injures the lung during a therapeutic puncture (installation of a central venous route, that is to say the installation of a catheter in a large vein at the base of the neck) or diagnostic (puncture of a pleural effusion for example).
Treatment
Treatment for secondary pneumothorax can be simple observation in a hospital setting if it is not important, placement of a pleural drain, or sometimes surgery.

Number of days of hospitalization 2 – 3 days

This information is given as an indication and must be transmitted by a doctor on the day of your treatment.

The information contained on this site should not be used as a substitute for a medical consultation. Always speak with your doctor for information on diagnosis and treatment.