PNEUMOTHORAX

BY
Dr. IBNU DHARMAJATI
 DEFINITION

A pneumothorax refers to a
collection of gas in the pleural
space resulting in collapse of the
lung on the affected side
 PATHOPHYSIOLOGY
 A tension pneumothorax results from any lung
parenchymal or bronchial injury that acts as a
one-way valve and allows free air to move into
an intact pleural space but prevents the free exit
of that air.
In addition to this mechanism, the positive
pressure used with mechanical ventilation
therapy can cause air trapping.
 PATHOPHYSIOLOGY

 As pressure within the intrapleural space

increases, the heart and mediastinal structures
are pushed to the contralateral side. The
mediastinum impinges on and compresses the
contralateral lung.
 CLASIFICATION
1) Based on causes:
a) Spontaneous pneumothorax:
primary/idiopathic
secondary
b) Traumatic pneumothorax
c) Artificial pneumothorax
d) Iatrogenik pneumothorax

2) Based on fistula:
a) Closed pneumothorax
b) Open pneumothorax
c) Tension pneumothorax
SYMPTOMS AND SIGNS

 Spontaneous chest pain

 Spontaneous dyspnea
 Anxiety
 Fatigue
 Haemoptisis
 Physical Examination
 Respiratory distress or respiratory arrest
 Unilaterally decreased or absent lung sounds
 Adventitious lung sounds (crackles, wheeze; an
ipsilateral finding)
 Tachypnea; bradypnea (as a pre-terminal event)
 Hyperresonance of the chest wall on percussion
 Hyperexpansion of the chest wall
 Tachycardia (a common finding)
 Tracheal deviation
 CAUSES
 A wide variety of disease states and circumstances
increase the patient's risk of a pneumothorax
 Aspirated meconium may serve as a one-way valve and
produce a tension pneumothorax.
 Trauma
 Many procedures performed in an intensive care or
emergency setting (incorrect chest tube insertion,
mechanical ventilation therapy, central venous
cannulation; cardiopulmonary resuscitation; hyperbaric
oxygen therapy; needle, transbronchial, or transthoracic
lung biopsy; liver biopsy or surgery; and neck surgery)
 CAUSES
 Secondary or spontaneous pneumothorax is
possible in many medical conditions;
associated with asthma, chronic obstructive
pulmonary disease, pneumonia, pertussis,
tuberculosis, lung abscess, and cystic fibrosis.
CLINICAL TREATMENT
 Observation
 Oxygen
 Water Sealed Drainage (WSD)
 Pleurodesis
 Thoracotomy
 COMPLICATIONS
 Respiratory distress and/or arrest
 Cardiac arrest
 Pulmonary edema (following lung re-expansion)
 Empyema
 Persistent bronchopulmonary fistula
 Pneumomediastinum
 Pneumopericardium
 Pneumoperitoneum
 Pyopneumothorax
 Hemopneumothorax
 Prognosis

 The prognosis is generally good with

appropriate therapy, but it varies depending on
the etiology.
PNEUMOTHORAX
RADIOGRAPHY
THANK YOU…..
^-^”