Pneumothorax : presentation and management

Pneumothorax, the medical term for a collapsed lung, represents a clinical condition that can range from asymptomatic to life-threatening. It occurs when air enters the pleural space, the slim, fluid-filled gap between the lung and chest wall. This can lead to a partial or complete collapse of the affected lung, creating a sudden onset of chest pain and breathlessness which primary care clinicians must promptly recognize and manage.

The aetiology of pneumothorax is varied, encompassing spontaneous occurrences in otherwise healthy individuals—referred to as primary spontaneous pneumothorax (PSP)—to those associated with underlying lung pathology, known as secondary spontaneous pneumothorax (SSP). Traumatic pneumothorax, another critical variant, is a direct result of chest injury, while iatrogenic pneumothorax can occur as a complication of medical procedures.

The incidence of PSP peaks in young adults aged between 20-30 years, with a notable male predominance, and can often recur. SSP, however, typically presents in an older demographic with existing pulmonary conditions, such as COPD, making the consequences potentially more severe. Understanding the epidemiology and pathophysiology of pneumothorax is crucial for primary care providers, as early detection and appropriate referral can significantly alter the course of treatment and prognosis.

From a clinical standpoint, the presentation of...