A pneumothorax is a collection of air within the pleural space.

There are two major types of pneumothorax:

  • Spontaneous 
  • Tension 

Generally, the aetiology and risk factors are similar for both types.

However, the underlying pathophysiology is slightly different leading to different consequences and management for each type.


Chest radiograph demonstrating large left-sided pneumothorax

AP chest radiograph demonstrating a spontaneous left-sided pneumothorax. Image courtesy of Wikimedia commons.

Spontaneous pneumothorax

Spontaneous pneumotharaces may be either primary or secondary

  • Primary spontaneous pneumothorax (PSP) - occur spontaneously in a previously non-pathological lung; typically seen in tall, thin young men.
  • Secondary spontaneous pneumothorax (SSP) - occur in previously diseased lungs; common causes include COPD and asthma

It is thought that in both types the underlying mechanism is due to the rupture of lung blebs and bullae. These are small pockets of air that form within the lung parenchyma.

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