In pneumothorax (thesaurus synonyms: Acute pneumothorax; Bacterial hemothorax; Chronic pneumothorax; Hematopneumothorax; Hematothorax; Hemopneumothorax; Hemothorax; Hydrohematopneumothorax; Hydropneumohemothorax; Lung injury with hematopneumothorax; Pulmonary injury with pneumohematothorax; Pulmonary injury with pneumothorax; Non-tuberculous hemothorax; Open injury with pneumothorax; Pneumohematothorax; Tension pneumothorax; Spontaneous tension pneumothorax; Spontaneous pneumothorax a. n.k.; Traumatic hematopneumothorax; Traumatic hemothorax with pneumothorax; Traumatic pneumothorax; Valve pneumothorax) is a collapse of the lung caused by an accumulation of air between the visceral pleura (lung pleura) and the parietal pleura (chest pleura). In most cases, pneumothorax occurs acutely.
A life-threatening form of pneumothorax is tension pneumothorax. This occurs when air enters the pleural space through an injury without being able to escape.
The following forms of pneumothorax (according to the ICD-10) can be distinguished:
- Spontaneous tension pneumothorax (J93.0) – life-threatening form of pneumothorax in which increased pressure in the pleural space causes problems with blood flow to the heart as well as limited expansion of the reciprocal lung; pleural space is the space in the thoracic cavity between the inner upper surface of the chest and the pleura
- Other spontaneous pneumothorax (J93.1).
- Iatrogenic pneumothorax (J93.2) – collapse of the lung caused by a medical procedure
- Other pneumothorax (J93.8).
- Hematopneumothorax (J94.2) – collapse of the lung characterized by accumulation of air and blood
- Traumatic pneumothorax (S27.0) – pneumothorax resulting from an injury
- Traumatic hematopneumothorax (S27.2) – hematopneumothorax caused by injury
Furthermore, one can distinguish:
- Primary (idiopathic, juvenile) pneumothorax – without underlying lung disease.
- Secondary pneumothorax – due to pre-existing lung disease (>50% due to COPD).
- Closed pneumothorax – here is no connection between the chest cavity and outside air.
- Open pneumothorax – here there is a connection between the chest cavity and the outside air.
Sex ratio: primary spontaneous pneumothorax affects men significantly more often than women. The sex ratio males to females is 7: 1.
Frequency peak: primary spontaneous pneumothorax occurs mainly in younger men, between 15 and 35 years. Secondary spontaneous pneumothorax occurs primarily in older individuals. The peak age is 65 years.
The incidence (frequency of new cases) for primary spontaneous pneumothorax is 7-14.3 cases per 100,000 population per year (in Germany). The incidence for secondary spontaneous pneumothorax is slightly lower than for primary.
Course and prognosis: A minor pneumothorax is usually not noticed by the patient and heals spontaneously (by itself). In most cases, pneumothorax is treated as an inpatient. Spontaneous pneumothorax is often recurrent (recurring). The recurrence rate is 30% (without thoracoscopic therapy).
More than 90% of those affected by primary spontaneous pneumothorax are smokers. In this respect, not smoking is the most effective protective measure.
For young healthy people, spontaneous pneumothorax is hardly life-threatening. With increasing age, on the other hand, mortality (number of deaths in a given period of time, relative to the number of the population in question) increases up to 10%.