November 2002, Volume 32 Number 11 , p 74 - 76
Outline What causes traumatic, iatrogenic, and spontaneous pneumothorax?
What to look for
What tests tell you
How to treat pneumothorax
Graphics Figure. Tension pneu...
PNEUMOTHORAX IS an accumulation of air in the pleural space that leads to partial or complete lung collapse. In some cases, venous return to the heart is impeded, causing a life-threatening tension pneumothorax.
Pneumothorax is classified as traumatic, iatrogenic, or spontaneous:
* traumatic pneumothorax may be further classified as open (sucking chest wound) or closed (blunt trauma or bleb rupture). Note that an open or penetrating wound may cause a closed pneumothorax if communication between the atmosphere and the pleural space is sealed off.
* iatrogenic pneumothorax occurs during a procedure such as subclavian central line insertion.
* spontaneous pneumothorax , which also is considered closed, can be further classified as primary (idiopathic) or secondary (related to a disease).
Tension pneumothorax can develop from traumatic, iatrogenic or spontaneous pneumothorax.
What causes traumatic, iatrogenic, and spontaneous pneumothorax?
A traumatic open pneumothorax or a hemothorax (accumulation of blood in the pleural cavity) may be caused by a penetrating injury, such as a stab wound, a gunshot wound, or an impaled object.
A traumatic closed pneumothorax or a hemothorax may be caused by a car crash, fall, or crushing chest injury. Blunt chest trauma causes lung tissue to rupture, resulting in air leakage from the lung into the pleural space. Increased pleural pressure prevents lung expansion during inspiration.
Iatrogenic pneumothorax may result from:
Figure. Tension pneumothorax * insertion of a central line
* thoracic surgery
* pleural or ...