Collapsed lung (pneumothorax)

A collapsed lung happens when air gets into the space between the lung and the chest wall.

This air can come from:

• inside the lung, through a hole in the lung
• outside the chest, through a hole in the chest wall.

Once in the space between the lung and the chest wall, the pressure of the air squashes the lung. This causes it to collapse, either partially or completely, making it hard to breathe.

A collapsed lung can be caused by an injury to your chest, such as a chest wound in a car crash or in an assault. It can also be caused by some lung diseases, such as:

• chronic obstructive pulmonary disease
• lung cancer
• pneumonia.

The most common cause of a collapsed lung is a small tear in the lining of the lung that happens for no known reason. This is called a spontaneous pneumothorax.

You are more likely to get a spontaneous pneumothorax if you are:

• tall and thin
• a smoker.

If you have a collapsed lung, you will:

• be short of breath
• feel a sharp stabbing pain that is worse when you breathe in or cough.

How bad your symptoms are will mostly depend on how collapsed the lung is.

Too much air building up between the lung and the chest wall can cause a lot of pressure on the lung. This can make the lung push on your heart and the blood vessels that feed your heart.

This can be very serious as it reduces the ability of the heart to pump effectively. This is called a tension pneumothorax. It is an emergency that needs to be treated immediately.

Talk to your healthcare provider if you are:

• displaying minor symptoms
• worried you may have a collapsed lung.

They will:

• examine your chest
• arrange a chest x-ray.

If the air leak is small, your body will usually reabsorb the air and heal the tear by itself. This may take anything from a few days to several weeks.

If the air leak is larger, you will need help to remove some of the air. In this case, you will have to go to hospital to have it removed. This can be done either by needle or by chest drain.

Needle

If the amount of air is small and the lung is only partially collapsed, the air may be removed through a needle.

You will have a local anaesthetic to numb the area so that the procedure does not hurt. Then, a needle will be inserted into the space between your lung and chest wall to draw out the air.

Chest drain

If the air leak is large or keeps happening after it has been drained by a needle, you may need it to be drained through a tube.

If you have a chest drain, the tube will probably be in your chest for a few days. You will need to stay in hospital until the air has been drained and your lungs have healed.

Repeated collapsed lung

Most people who have a collapsed lung do not experience it again. But it happens repeatedly in some people. If this happens, you will need to see a hospital specialist. They may recommend an operation to stop it from happening again.

This operation is called a pleurodesis. In it, the surgeon makes the lining of your lungs and chest wall (pleura) stick together. They either do this using a special chemical or by irritating them physically. After this, air leaks will not be able to happen. This procedure does not affect the way your lungs work.

Safety precautions

After you have been diagnosed with a collapsed lung, it is important not to fly until your healthcare provider has cleared you to do so. It is dangerous to fly with a collapsed lung because the air pressure around your lung does not drop when the cabin air pressure drops. This can make the pneumothorax get bigger or damage the surrounding tissue.

If you scuba dive or freedive, you will not be able to again, even after your lung has healed. This is because of the risk of your lung collapsing again when you are underwater. If you dive as part of your job, talk to a dive doctor about possible options.