Pneumothor Pneumothorax and Its Ax and Its Consequences

PneumothorPneumothoraxax andand ItsIts ConsequencesConsequences DAN Offers Advice on Penetration of the Lungs

Q: After sustaining a fractured pneumothorax the expanding gas assumed that the underlying lung rib and pneumothorax during a volume in the pleural space compresses tissue is damaged, and scarring of sports injury, a diver has asked the lung and heart. This condition is the lung and pleura may increase why he could never dive again. considered very serious and requires the risk that pulmonary barotrauma What is the risk of a emergency treatment. If it were to will occur during diving. spontaneous pneumothorax? occur in a diver underwater, the Could scarring of the pleura increase in pressure within the pleural A person with this type of injury would cause any problems? space would be compounded by gas require an evaluation prior to scuba expansion as the diver heads for the diving. The presence of any abnormal surface. shadows within the lung on a chest X- The lungs are contained in the A: ray or CT scan suggests an increased chest cavity within the pleural This young man who has asked about risk of air-trapping and reduction in membrane. The pleura lines the exterior diving after this type of injury elasticity. Thus, he might be advised of the lungs and the interior of the sustained a fractured rib and a that the risk of barotrauma is too great chest cavity with a potential space pneumothorax from a sports injury. to consider diving. between the two layers. If air enters We assume this was blunt trauma, the area between the pleural tissues, the which fractured the rib and the A spontaneous pneumothorax can potential space becomes an actual pneumothorax, but that the broken rib occur with no warning to an apparently space. If the space expands, the lung did not penetrate the pleura and lung. healthy person. This is due to a lung expansion is reduced, and respiration A pneumothorax can result from blunt defect, which may be congenital or is compromised. trauma to the chest, causing the pleura may appear later in life. The recurrence to tear, much like popping an inflated rate of this type pneumothorax is high, If the air comes from an interior paper bag. and, for that reason, these individuals wound, it is called a closed are usually advised not to dive. The risk pneumothorax, and if the wound is What is the chance of this area is that a spontaneous pneumothorax external, it is called an open rupturing again, producing a might occur while diving, resulting in a pneumothorax. The opening may spontaneous pneumothorax? If the closed air space, which could not be result from a lung defect or an injury mechanism of the injury was as just equalized as the diver ascends. The (trauma). The larger the hole, the more described, the injured area should heal resulting expansion of this air space rapid the progression of the adequately within a few months, with with decreasing ambient pressure pneumothorax. very little risk of a spontaneous would interfere with the function of pneumothorax as a result of this injury. the heart and the other lung, with If the hole is small, the pneumothorax The lung itself probably suffered little possible disastrous consequences. may self-seal, and the body will if any damage from this injury. gradually reabsorb the air. If the If you have questions about interior wound does not close and air However, if a chest injury results pneumonthorax, see your diving continues to enter the space, the in penetration of the lung by a doctor or contact DAN. condition is called tension broken rib, a gunshot, a knife or pneumothorax. In tension other sharp object, then it is often

Original text by G. Yancey Mebane, M.D., DAN America Associate Medical Director, Retired, with recent modifications by Richard Moon, M.D., DAN America Vice President and Medical Director.

Alert Diver, SEAP 36