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Video: Pneumothorax

Video: Pneumothorax
Video: Pneumothorax 2023, September


With a pneumothorax, air enters the pleural space, the gap between the lungs and the chest wall (between the pleura and the pleura). As a result, the lungs can no longer expand as before. She collapses. It can even lead to a medical emergency.

The causes of a pneumothorax are different, it occurs for example as a result of lung diseases or injuries. In most cases, an inpatient stay is necessary for therapy.


  • Continue reading
  • more on the subject
  • Advice, downloads & tools
  • Pneumothorax - what is it?
  • to shape
  • Symptoms
  • diagnosis
  • therapy
  • Whom can I ask?
  • How are the costs going to be covered?

Pneumothorax - what is it?

Normally, when you inhale, the lungs expand up to the chest wall, so that the gap between the lungs and chest wall is very small. The lungs contract as you exhale. Due to the negative pressure in the gap between the lungs and the chest wall, the lungs are more or less "sucked" into the chest wall, which physiologically prevents the lungs from collapsing.

Illustration pneumothorax © joshya

If air penetrates the pleural space, the negative pressure is released. The lungs can no longer follow the movements of the chest and partially or completely collapse (collapse). Breathing is restricted, in the worst case the breathing function of the lungs fails.

to shape

The pneumothorax can have various causes. A distinction is made among others:

  • Spontaneous pneumothorax. This occurs spontaneously and through the bursting of alveoli, causing air to escape. There are two forms:

    • Primary spontaneous pneumothorax, which has no identifiable cause and which occurs in healthy lungs. Smoking is considered a risk factor. It has also been observed that this form of pneumothorax can occur more frequently in close relatives. Tall, lean men are mostly affected.
    • Secondary spontaneous pneumothorax, which occurs as a result of an existing lung disease, e.g. COPD, emphysema, cystic fibrosis.
  • Traumatic pneumothorax. Through injuries to the chest, e.g. after car accidents, stab wounds.
  • Iatrogenic pneumothorax. As a complication of a medical procedure, e.g. as a result of a puncture.
  • Tension pneumothorax. With this form, the air that penetrates the pleural space can no longer escape (valve mechanism). With every inhalation, more air collects in the pleural space. The lungs collapse (one side). The high pressure displaces the lungs, heart and large vessels. It must be treated immediately, because the increasing pressure poses an acute risk to life (circulatory failure). The tension pneumothorax is a medical emergency!


A pneumothorax can be shown by:

  • Shortness of breath,
  • sudden pain (one-sided in the chest area, stabbing, especially when breathing deeply) and
  • Throat irritation.

Symptoms start suddenly. Worsening through exertion and breathing. With tension pneumothorax, palpitations, drop in blood pressure, etc. occur. If there is a medical emergency, e.g. severe or increasing shortness of breath, the emergency call must be dialed immediately (144). For more information, see Emergency: Emergency: Difficulty breathing in adults.


The diagnosis is based on the physical condition of the person affected. Symptoms give the doctor hints. This person collects the medical history (e.g. inquires about the type of pain, previous illnesses, smoking etc.) and carries out physical examinations (e.g. listening, tapping, identifying signs of possible chest injuries). An x-ray is also arranged.

The following examinations can possibly also be carried out:

  • EKG
  • CT
  • Blood gas analysis
  • Thoracoscopy


The therapy is based on the shape or cause and size of the pneumothorax and the general condition of the person affected. In most cases, an inpatient stay is necessary. The therapy aims to remove air from the pleural space and prevent relapse. This is done through various measures:

  • Observation and waiting for spontaneous healing. Check-ups, changes in behavior (quitting smoking) and administration of oxygen (oxygen therapy, breathing through a mask) are arranged. This is considered in the case of a small spontaneous pneumothorax, for example.
  • Air aspiration. A puncture is made under local anesthesia and air is drawn off with a syringe.
  • Pleural drainage. This is also done under local anesthesia. Air is sucked out through a tube that is inserted into the pleural space. A pump system provides the necessary negative pressure. After removing the drainage, the wound is closed with a plaster or a suture. Treatment is carried out in a hospital.
  • Pleurodesis. The space between the pleura and pleura is "glued" (desolated) in order to prevent the lungs from collapsing, for example with talcum powder over the pleural drainage. This can also be done during an operation.
  • Surgery. Holes can be treated surgically or glued. This is done using a minimally invasive operation (endoscopic, video-assisted thoracoscopy - VATS). Sometimes a lateral opening of the rib cage is necessary.
  • In general, smoking should be avoided. A recurrence of pneumothorax is possible.

Whom can I ask?

If symptoms appear that could indicate a pneumothorax - e.g. shortness of breath, sudden unilateral pain in the chest area (especially when breathing deeply) or an urge to cough - an immediate medical consultation is necessary!

Note The emergency doctor (144) must be informed immediately in the event of a correspondingly poor condition (e.g. acute shortness of breath, palpitations, drop in blood pressure) or deterioration in the condition of the person concerned. For more information on dyspnea and first aid measures, see Emergency: Difficulty breathing in adults.

In the case of a pneumothorax, doctors from various disciplines can be involved in the treatment, e.g. pulmonary medicine, surgery (thoracic surgery), cardiology, etc. The acute treatment takes place in special centers (e.g. department of a hospital for internal medicine, specializing in pneumology).

How are the costs going to be covered?

The costs for diagnosis and treatment of a pneumothorax are usually covered by the responsible health insurance company. For more information on costs for a hospital stay, see What does a hospital stay cost?

Your doctor will generally settle accounts directly with your health insurance provider. However, you may have to pay a deductible with certain health insurance providers. You can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Visit a Doctor: Costs and Deductibles.

For information on the prescription fee, see The Prescription.

For information on the respective provisions, please contact your health insurance provider, which you can find on the social security website.

The literature used can be found in the bibliography.