The pneumothorax is the presence of air in the pleural cavity. Primary spontaneous pneumothorax is called when secondary pneumothorax occurs in apparently healthy individuals, and when it is associated with the most common lung disease, COPD.
The spontaneous pneumothorax Primary appears in tall, thin young, between 20 and 30 years and with a higher incidence in men than in women ( 8-28 cases per 100 000 inhabitants each year in males). The Smoking increased to 20 times the risk of such events.
Causes and symptoms of pneumothorax
In cases of primary spontaneous pneumothorax, although the causes are not well established, most patients have small bullae or blebs subpelurales whose failure causes the output of air intrapulmonary to the pleural cavity causing pneumothorax.
As for your symptoms, the most common is that the patient noticed a pleuritic pain, as a stab in the hemithorax where there has been pneumothorax, I accompanied at the same time a feeling of suffocation. The pain can be mild or severe in the beginning, and is often fading over time.
Treatment of pneumothorax
The key management, as in all benign and good prognosis disease, is to get the reexpansion pulmonary and prevent recurrence occurs in 30-50 % of cases. When a second episode takes the possibility of a third or subsequent is much higher, so a surgical treatment is recommended with radical purpose.
In the small pneumothorax can advise conservative treatment, relative rest without practicing intense physical exercise, never advised complete rest in bed because it improves lung reexpansion or air reabsorption in the pleura.
However, most cases are treated by air evacuation placing a small drainage under local anesthesia that is connected to a suction system, thus the evacuation of air and pulmonary reexpansion is achieved in 24-48h in 85% of cases.
In cases where pulmonary reexpansion is not reached, after a period of aspiration of 5-7 days, or in cases of recurrent pneumothorax (two or more episodes ) advised surgical treatment, which requires general anesthesia and in most cases is done by VATS and three entrance doors 10-20mm, the pleural cavity is reviewed, the pathological formations blebs or bullae if any are removed and pleural abrasion is performed to cause symphysis or adhesions of the two pleural layers.
The period of income ranges 3 to 5 days, and the pneumothorax with this technique are settled permanently in 95 % of cases.