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  • Collapsed lung
  • Spontaneous pneumothorax
  • Pneumothoraces (plural form of disorder)

  • 512.0 Pneumothorax and air leak
  • 860 Traumatic pneumothorax and hemothorax

  • 780.7 Malaise and fatigue
  • 786.0 Dyspnea and respiratory abnormalities
  • 786.05 Shortness of breath

  • J93.0 Spontaneous tension pneumothorax
  • J93.11 Primary spontaneous pneumothorax
  • J93.12 Secondary spontaneous pneumothorax
  • J93.81 Chronic pneumothorax
  • J93.82 Other air leak
  • J93.83 Other pneumothorax
  • J93.9 Pneumothorax, unspecified
  • J95.811 Postprocedural pneumothorax
  • J95.812 Postprocedural air leak
  • S21.309A Unspecified open wound of unspecified front wall of thorax with penetration into thoracic cavity, initial encounter
  • S27.0XXA Traumatic pneumothorax, initial encounter
  • S27.1XXA Traumatic hemothorax, initial encounter
  • S27.2XXA Traumatic hemopneumothorax, initial encounter

Description

  • Collapsed lung occurs from air in the region around the lung
  • Pressure on the lung prevents expansion of the lung with inhalation
  • Chest pain with breathing

Essentials of Diagnosis

  • Spontaneous pneumothorax (PTX) can occur with no etiology
  • Focal area of absent breath sounds2
  • Iatrogenic PTX4
    • From a complication from a diagnostic or treatment procedure
  • Tension PTX4
    • Air enters the pleural space but can not escape
  • Primary pneumothorax
    • Unknown cause
  • Secondary pneumothorax
    • Known cause

General Considerations

  • Can be caused by
  • Can be life threatening
  • May need a chest tube

Demographics

  • More common in tall and thin individuals
  • Spontaneously in newborns and in older children
  • Males (16 to 24) with high risk trauma activities3

Signs and Symptoms

  • Sudden shortness of breath2
  • Focal area of absent breath sounds2
  • Chest pain; worsens with deep breath or cough
  • Cyanosis
  • Fatigue
  • Increased heart rate
  • Decreased oxygenation throughout the body
  • Nasal flaring
  • Hypotension (low blood pressure)
  • Chest tightness
  • Raising shoulders allows increased lung air flow
  • Tensed muscles from dyspnea

Functional Implications

  • If spontaneous pneumothorax, patient prohibited from air travel until completely healed
  • Disabling dyspnea when performing simple tasks
    • Arm elevation to reach into cabinet
    • Decreased exercise tolerance
    • Inability to function at work secondary to respiratory problems

Possible Contributing Causes

  • Having had a previous pneumothorax
  • Rib fracture
  • Gunshot to lungs
  • Puncture wound to lungs
  • Lung rupture (small region)
  • Acute complication of tracheostomy2
  • Asthma
  • Measles
  • Congenital malformation
  • Smoking
  • Cystic fibrosis
  • Tuberculosis
  • Whooping cough
  • Chronic obstructive pulmonary disease (COPD)

Differential Diagnoses

  • Diaphragmatic hernia
  • Influenza
  • Measles
  • Asthma
  • Chickenpox
  • Gastroesophageal reflux disease (GERD)
  • Ludwig’s angina
  • Bronchiectasis
  • Congenital lobar emphysema
  • Cystic fibrosis (CF)
  • Kawasaki disease (KD)
  • Bronchitis
  • Goiter
  • Upper respiratory tract infection
  • Central airway ...

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