A pneumothorax occurs when air gets between the lung and the inside of the chest wall, causing the lung itself to collapse. These air spaces can vary in size; some small enough to resolve on their own, others requiring surgery. One-time pneumothorax may be caused by a penetrating chest injury, a rib fracture or lung disease such as emphysema.
Pneumothorax tends to occur mostly in teenagers and young adults, especially those that are tall and thin. It also occurs in a small percentage who have a connective tissue disorder which causes the lung to develop cysts (called blebs or bullae), which can rupture into the space between the lungs and the chest wall (pleural space).
Symptoms may include chest or shoulder pain — especially when breathing deeply or coughing, shortness of breath, widening nostrils, bluish skin color, lightheadedness, fainting, tiring easily, and rapid heart rate.
Occasionally, the pneumothorax is small enough to go away on its own — under observation. Otherwise, the air in the pleural space must be removed and the lung reinflated. This is typically done by surgically inserting a chest tube into the space, and sucking out the air. If the condition is recurrent, an abrasion on the inside surface of the chest wall may be performed during the surgery, to encourage proper adhesion of the lung to the chest wall.