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Pneumothorax

What is a pneumothorax?

A pneumothorax is where air leaks out of the lung. This air becomes trapped between the space between the outside of the lung and the inside of the ribcage (an area called the pleural space). The air can squash the lung and cause some or all of the lung to collapse. The condition is sometimes known as a ‘punctured lung’.

What causes a pneumothorax?

Sometimes the air leak happens suddenly, for no apparent reason, in an otherwise healthy child. This is called a ‘primary spontaneous pneumothorax’ and happens most often in older teenagers, especially tall, thin boys.
Existing lung conditions, such as asthma or cystic fibrosis, can weaken the surface of the lung and make it more likely to tear. When this happens it is a called a ‘secondary spontaneous pneumothorax’.
Finally, a pneumothorax can also occur when there has been an injury to the chest which damages the surface of the lung.
In babies, air leaks can also happen if they:
  • have breathing problems, such as respiratory distress syndrome
  • have breathed in meconium (baby’s first poo) before they are born
  • are premature
Pneumothorax in babies often occurs in the first couple of days after birth

What are the symptoms of a pneumothorax?

The main symptoms of a pneumothorax are chest pain and breathlessness. The symptoms will often come on suddenly and the pain is typically sharp in nature, affecting one side of the chest, and worsens on breathing in.

How is a pneumothorax diagnosed?

When the doctor examines your child they may find signs that point towards a pneumothorax, although this is often not the case if the pneumothorax is small. A chest X-ray is used to confirm the diagnosis in most cases.

How do you treat a pneumothorax?

If the pneumothorax is small and your child is not particularly breathless then they may be allowed to go home. In most of these cases the pneumothorax will heal on its own, although this can take several weeks. We will arrange to see you back for follow up at the hospital with a specialist team.

If the pneumothorax is big, or if your child is quite breathless, then we will need to insert a small draining tube (called a chest drain) between the ribs to allow the trapped air to escape. In older children this can be done using local anaesthetic, although in younger children sedation or general anaesthetic may be needed to allow us to put the chest drain in. The doctor will talk to you in more detail about this procedure before it is performed. Your child will then be admitted to hospital until the drain can be removed.

What should I look out for at home?

Return immediately to the Emergency Department if your child seems more breathless or unwell, or if you have any other concerns.

It is common for children to have discomfort in their chest with a pneumothorax. Pain killers, such as paracetamol every 4 to 6 hours, are advisable, and you can add ibuprofen every 6 to 8 hours if needed. Return to the Emergency Department if the pain gets significantly worse or if you are not able to control it.

What do I need to know for the future?

Avoid plane travel

Your child must not fly until they have been told it is safe to do so by the doctor. This is only advisable when the pneumothorax has completely resolved, which may take several weeks.

Avoid scuba diving

Your child must never go scuba diving unless they undergo a surgical procedure to prevent a pneumothorax happening again. The specialist can discuss this further with you in the outpatient clinic if you wish.

Can a pneumothorax happen again?

Yes, it is not uncommon for children to have another pneumothorax at some point. It is therefore important to seek urgent medical advice if your child develops similar symptoms in the future. If the condition does occur again, depending on the underlying cause, the specialists may consider performing an operation to prevent further episodes.

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Disclaimer

Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: ED35

Resource Type: Article

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