Pneumothorax is defined as the presence of air in the pleural cavity. Pleural cavity is the space between the lungs and the chest wall. This cavity helps in the functioning of the lungs during breathing. The space in the pleural cavity is separated by two layers i.e. visceral layer and parietal layer which are in contact with each other due the existence of surface tension on the moist surfaces. The pressure on the walls of the pleural cavity is high and forces the air from the lungs to escape leading to lung collapse. Thus, the capacity of the lung is drastically reduced leading to insufficient supply of oxygen to the body. The symptoms include shortness of breath and fatigue. The treatment approach depends upon the severity of the disease. If the patient is asymptomatic then the standard approach is to observe and put the patient under monitoring. However, in few cases, surgery is also recommended.

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What Are The Different Types Of Pneumothorax?

Pneumothorax is classified on the basis of various characteristics as discussed below:

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  1. Classification Of Pneumothorax On The Basis Of Time

    • Chronic: When the pneumothorax is developed in the patient for a longer period the condition is termed as chronic pneumothorax. The treatment strategy advised by the physician is to prevent the recurrence of the symptoms in these patients.
    • Acute: When the pneumothorax is sudden, and the symptoms are moderate to severe, the condition is termed as acute pneumothorax. These symptoms, if severe, require immediate medical attention.
  2. Classification Of Pneumothorax On The Basis Of Organ Involvement

    • Localized Pneumothorax: When only the parietal and visceral layers are involved in the disease, then it is termed as localized pneumothorax.
    • Generalized Pneumothorax: When the whole of the cavity is involved in the disease, then it is termed as generalized pneumothorax.
  3. Classification Of Pneumothorax On The Basis Of Cause Of Pneumothorax

    Non-Traumatic Pneumothorax: It is also called as spontaneous pneumothorax as there is no injury to cause pneumothorax. This pneumothorax is further divided in to following two types:

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    1. Primary Spontaneous Pneumothorax: This is the type of spontaneous pneumothorax wherein there is no presence of the underlying disease.

    2. Secondary Spontaneous Pneumothorax: This type of pneumothorax is characterized by the underlying disease such as chronic asthma, Chronic Obstructive Pulmonary Disease (COPD) or cystic fibrosis. This pneumothorax is more dangerous than primary spontaneous pneumothorax and the treatment also includes drugs for the underlying disease.

      • Traumatic Pneumothorax: This type of pneumothorax occurs due to some injury in the chest. The injury may include motor vehicle accident, bullet wound, or other penetrating chest trauma.
      • Iatrogenic Pneumothorax: This pneumothorax occurs due to diagnostic or therapeutic procedure thoracentesis, esophageal perforation, mechanical ventilation or transthoracic lung biopsy.
  4. Classification Based On Pathophysiology

    • Open Pneumothorax: When the air enters in the pleural cavity while inhalation and leaves the cavity during exhalation it is known as open pneumothorax.
    • Closed Pneumothorax: When the air enters in the cavity, but fails to move out during exhalation, it is known as closed pneumothorax. It may occur when the hole through which the air enters gets blocked and the air failed to escape.
    • Valvular Pneumothorax: Valvular pneumothorax may lead to tension pneumothorax as the pressure in the pleural cavity is progressively increased. The lung collapses which leads to the compression of the vena cava and development of pressure on mediastinum. This leads to reduction in the venous return and cardiac output and result in hypotension and cyanosis.

Conclusion

When the air is filled in the pleural cavity due to any reason, it leads to collapse of the lungs. This collapse of the lung due to air in pleural cavity is known as pneumothorax. The pneumothorax is classified in various types depending upon the characteristics for classification. Pneumothorax can be classified on the basis of cause, pathophysiology, time frame and involving organs. The pneumothorax with severe symptoms should require immediate medical intervention otherwise the patient may face fatal the consequences.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: October 5, 2018

This article does not provide medical advice. See disclaimer

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