Difficulty breathing to the point of shortness of breath, chest pain and irritation of the cough – these are considered typical signs of a ruptured lung. A tear in the tissue of the lung is usually due to external force, diving or lung disease. If a ruptured lung is suspected, see a specialist immediately – either a respiratory expert (pulmonologist) or a lung specialist (pulmonologist).
What is a ruptured lung?
A ruptured lung refers to an injury to the lung that can lead to complications. There is a tear in the tissue of the lung, causing breathing air to escape from the lung. In parallel, air enters the lungs through the pleural space, the gap between the lung pleura and the pleura, which is why the negative pressure in the organ falls. Breathing causes considerable problems – a collapsed lung or so-called pneumothorax is the result. This occurs when the lung or pleura is injured and can even be life-threatening. If a ruptured lung is suspected, medical advice and appropriate help should be sought in any case. The physician primarily provides ventilation with oxygen and takes measures against coughing. In severe cases, he performs air aspiration or places a drain.
Causes
It is considered proven that deliberately causing a ruptured lung is impossible in a healthy person. However, as for the exact cause of a ruptured lung – here the final clarification is still pending. A ruptured lung apparently has three main causes: In addition to a disease of the lungs, these are external violence and diving. Lung diseases that promote lung rupture include pneumonia and pulmonary tuberculosis as well as pleurisy and lung cancer. An external force that can lead to a ruptured lung is pressure blows to the chest (e.g., explosions) while the mouth is closed. Divers can suffer a ruptured lung as a result of ascending too quickly. This occurs when the increasing air in the lungs cannot escape as the external pressure decreases. In this case, it is referred to as air trapping. Also, a, during the ascent and caused by the inhalation of water drops, tightening of the glottis can lead to an injury of the lungs, because the breathing air can not escape.
Symptoms, complaints and signs
A ruptured lung is first manifested by acute shortness of breath. Sufferers suddenly have difficulty catching their breath, breathe faster than usual, and usually also suffer a panic attack. Breathing difficulties, which occur regardless of physical exertion, are usually accompanied by unmediated chest pain, usually limited to one side. Deep breaths are accompanied by stabbing pain in the area of the lungs that is slow to subside. Often, deep breaths are no longer possible because the pain is too intense. If no immediate treatment is given, breathing air can enter the pulmonary veins and cause an embolism. In extreme cases, this cuts off the blood supply to the brain, spinal cord, or cardiac spasm vessels. This can cause neurological deficits, paralysis and cardiovascular problems, including heart failure or circulatory collapse. Accompanying this, organs and individual systems in the body fail. Usually, blood pressure rises and heart rate increases. As a result of a ruptured lung, inner restlessness usually occurs, combined with sleep disturbances and increased irritability. As the disease progresses, muscular activity initially fails before multiple organ failure and eventual death of the affected person occur.
Diagnosis and course
A ruptured lung does not always have to be associated with specific symptoms – it may even progress without symptoms. However, this is the exception rather than the rule. In addition to chest pain, dyspnea and difficulty breathing are usually the main indicators of a ruptured lung. Sudden shortness of breath combined with rapid breathing despite physical rest as well as pain on one side of the body in the chest area as well as coughing irritation are considered unmistakable signs of a ruptured lung. In the case of a ruptured lung, deep breathing is usually hardly possible – the pain is normally too great. The pain increases with exertion. In extreme cases, air bubbles can block the blood flow in the arteries of the spinal cord, in the coronary arteries and also lead to embolic occlusions in the brain.Collapse of the lung with pneumothorax is the result. Depending on the course of the disease, the ruptured lung can lead to respiratory failure, which is why there is ultimately a danger to life. Immediate action is therefore indicated if a ruptured lung is suspected. Both a pneumologist (respiratory expert) and a pulmonologist (lung specialist) can help. By listening and tapping on the upper body of the affected person, the doctor is able to detect any injury to the lungs with a high degree of certainty. If no breathing sound can be heard and the chest sounds hollow when tapped, this indicates a ruptured lung. The suspicion then becomes certainty by means of an X-ray. In addition, an ultrasound provides further information in the case of smaller tears. A computer tomography – although very costly and time-consuming – completes the picture. With its help, not only the actual injury can be detected, but furthermore other wounds as well as diseases, which are related to the lung tear.
Complications
A ruptured lung is a very serious complaint. It must be immediately examined and treated by a doctor, otherwise the patient will die. Sufferers primarily suffer from various respiratory problems as a result of the ruptured lung. This may include shortness of breath and further severe chest pain. The reduced supply of oxygen can also cause severe damage to the brain and internal organs, resulting in irreversible secondary damage. Furthermore, patients suffer from a coughing fit and are severely restricted in their lives. The undersupply of oxygen can also lead to a loss of consciousness. As a rule, this causes fatigue and reduces the patient’s ability to cope with stress. The rupture of the lung can also lead to pain, with the pain continuing to increase, especially during exertion. Treatment of this complaint must be performed in a hospital or by an emergency physician. Otherwise, the patient will die. No complications occur during the treatment itself. However, the further course of this complaint depends greatly on the timing of the treatment and the general condition of the patient. Possibly, the life expectancy is also reduced due to the rupture of the lung.
When should you see a doctor?
A tear in the lung can occur in varying degrees of severity, so it is not always necessary to see a doctor. A small hairline fracture in the lung may heal completely without seeking medical attention. Symptoms or pain do not occur in such a case, accordingly, the affected person often does not even notice the crack in the lung. However, if the tear is larger, acute respiratory distress may occur. Affected persons must receive urgent medical attention, otherwise death by suffocation is imminent. Such a tear does not grow closed on its own, so inpatient treatment in a hospital is essential. Only through medical and drug treatment can a tear in the lung be healed completely and promptly. If the affected person forgoes treatment by a doctor, severe complications and aggravations are to be expected. In some circumstances, even permanent consequential damage to the lung may occur, so that no proper recovery is possible. For this reason, a visit to the doctor should not be delayed. The larger the tear in the lung, the more acute and severe the pain during inhalation and exhalation.
Treatment and therapy
As a rule, any rupture of the lung requires treatment: only a small, spontaneously occurring rupture of the lung that does not cause any discomfort does not require medical treatment. Otherwise, if a ruptured lung is diagnosed, first aid must be administered immediately. If immediate treatment of the ruptured lung is not given, arterial gas embolism may occur if respiratory air enters the pulmonary veins. Immobilization of the upper body in an upright position should be initiated immediately. If the victim is a diver, then efforts should be made to warm up his body. If the victim is unconscious, the first priority is to transfer him to a stable lateral position while checking his breathing and blood pressure. If the victim is in medical care, he must be given pure oxygen for breathing. If resuscitation is necessary, pure oxygen should also be used as far as possible.If ventilation is performed on an inpatient basis, then this is done either by means of a face mask, a nasal tube or a breathing bag. In severe cases, it may be necessary to insert a thin tube into the lateral chest cavity – an incision makes this possible. This allows air to escape from the chest cavity.
Outlook and prognosis
A ruptured lung can be treated well, leading to favorable recovery prospects. This is even more true for minor injuries. These even heal on their own with appropriate rest. Additional administration of oxygen even leads to faster improvement. If a large lung rupture occurs, the air accumulation in the chest can be drained via a tube. Doctors around the world are trained to do this. Complications are very rare and mostly affect smokers. Some scientists believe there is an increased risk of a ruptured lung recurring in the first three months after it has healed. If left untreated, a ruptured lung often causes serious consequences. Above all, a life-threatening lung collapse is imminent. In addition to patients with a pre-existing lung disease, divers also belong to the risk group. However, the latter are often aware of the danger and are trained in first aid measures. Taking emergency measures immediately in the event of an acute illness is considered the best way to achieve a lasting cure. Once organ damage has been caused by a ruptured lung, it usually cannot be repaired. Patients are then left with only a life of great limitations. Life expectancy turns out to be comparatively low.
Prevention
Divers can prevent a ruptured lung by avoiding coughing underwater and hastily holding their breath. A general refrain from smoking is strongly advised for divers. Even with a slight cold, the planned dive should be postponed to a later time. A regular fitness test – preferably once a year – should be “mandatory” for a diver anyway. A listening to the respiratory tract as well as examinations of the lung function promise security for the next dive – enough air to breathe. Thus, the freestyle succeeds without any problems.
Aftercare
The rupture of the lung is a serious condition for affected persons and must be treated immediately by a doctor, otherwise the death of the affected person will occur. Affected individuals suffer from a constant coughing spell and are permanently restricted in their lives and daily routines. They are dependent on the help and support of relatives. Affected persons often have to take care of themselves even after the actual treatment. Regular check-ups with the treating physician ensure complete observation and can prevent the occurrence of further complications. However, the further course after treatment depends on the timing of the treatment and the state of health of the affected person. Whether life expectancy is shortened by the ruptured lung varies from case to case.
Here’s what you can do yourself
First aid must be given for a ruptured lung. While the emergency physician is called, the victim must be placed in the recovery position. It must also be ensured that the injured person can breathe and that there are no other injuries. The ruptured lung then requires medical evaluation and treatment. The affected person can apply some strategies and tips to support the medical therapy and promote recovery. First and foremost, this includes rest. A ruptured lung is usually caused by a serious lung disease or injury, which must be well cured to avoid complications. If breathing problems occur – especially in the first period after an operation, this can be the case – it is best to inform the doctor. In addition to prescribed medications, breathing and relaxation exercises can improve the flow of breath. Conscious relaxation also helps against panic attacks, for example through exercises from yoga or traditional Chinese medicine. Cough irritation can be counteracted with the help of herbal tea or warm milk. In the case of severe chest pain, cooling compresses or heat help, always depending on the nature of the complaints and the doctor’s recommendations.
