Pneumothorax classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Classification

Pneumothoraces are divided into tension and non-tension pneumathoraces.

• A tension pneumothorax is a medical emergency as air accumulates in the pleural space with each breath. The increase in intrathoracic pressure results in massive shifts of the mediastinum away from the affected lung compressing intrathoracic vessels.
• A non-tension pneumothorax by contrast is a less severe pathology because there is no ongoing accumulation of air and hence no increasing pressure on the organs within the chest.

The accumulation of blood in the thoracic cavity (hemothorax) exacerbates the problem, creating a pneumohemothorax.

Spontaneous Pneumothorax

Spontaneous Pneumothorax can be classified as primary spontaneous pneumothorax and secondary spontaneous pneumothorax. In primary spontaneous pneumothorax, it is usually characterized by a rupture of a bleb in the lung while secondary spontaneous pneumothorax mostly occurs due to chronic obstructive pulmonary disease (COPD).

Primary spontaneous pneumothorax

A primary spontaneous pneumothorax may occur without either trauma to the chest or any kind of blast injury. This type of pneumothorax is caused when ableb (an imperfection in the lining of the lung) bursts causing the lung to deflate. If a patient suffers two or more instances of a spontaneous pneumothorax, surgeons often recommend a bullectomy and pleurectomy. Primary spontaneous pneumothorax is most evident to people without any previous history of lung disease and in tall, thin men whose age is between 20 to 40 years old. But it can often occur in teenagers and young adults.

Secondary spontaneous pneumothorax

A known lung disease is present in secondary spontaneous pneumothorax. The most common cause is chronic obstructive pulmonary disease (COPD). However, there are several diseases that may lead to spontaneous pneumothorax:

• COPD
• Tuberculosis
• Pneumonia
• Asthma
• Cystic fibrosis
• Lung cancer
• Interstitial lung disease
• Marfan's Syndrome