Pneumothorax means a collapsed lung caused by air leaking into the space between the lung and the chest wall.
If you are searching for the meaning of a pneumothorax, the simplest answer is this: air escapes into the pleural space and presses on the lung from the outside, causing part or all of it to collapse. A lung pneumothorax can be small and mild, or large and dangerous. A pneumothorax is treated as a medical emergency when severe, especially if pressure builds up and starts to affect breathing or blood flow.
There are multiple types of pneumothorax.
You may also hear the terms open pneumothorax, closed pneumothorax, and tension pneumothorax. An open pneumothorax occurs when a chest wall opening allows outside air to enter the pleural space. A closed pneumothorax means the chest wall remains intact and the air leak comes from the lung itself. A tension pneumothorax is a dangerous condition in which air enters through a one-way valve mechanism in the chest wall or lung, so the air cannot escape from the pleural space, causing pressure to rise inside the chest, shifting the mediastinum, and quickly leading to respiratory failure and cardiovascular collapse. This is a life-threatening emergency.
Pneumothorax symptoms usually start suddenly and most often include chest pain and shortness of breath.
The pain is often sharp and may worsen with breathing. Difficulty breathing is one of the hallmark symptoms of a collapsed lung and should prompt immediate medical attention. Some people also develop a cough, rapid breathing, a rapid heart rate, fatigue, or a bluish tinge to the lips or skin when their lungs are not exchanging oxygen properly. Symptoms are often more severe when a larger portion of the lung has collapsed or when the person already has underlying lung disease.
In a small spontaneous case, the person may feel only mild discomfort. Symptoms of a small closed pneumothorax may include only minor chest pain and slight difficulty breathing. In a tension pneumothorax, difficulty breathing can worsen quickly and may be accompanied by severe distress, low blood pressure, and signs of shock.
In an open pneumothorax, there may be a visible chest wound with significant difficulty breathing. If you notice your breathing becoming more laboured or if you feel your lungs are not filling properly, these may be symptoms of a pneumothorax that requires urgent care.
You should seek urgent medical attention for a suspected pneumothorax, and a thoracic specialist review is especially important when symptoms are severe, the lung does not re-expand, or the condition recurs.
If you have severe chest pain and difficulty breathing, or if your lungs feel like they are not working normally, get emergency care immediately. A suspected pneumothorax is not something to monitor at home without assessment. Even if the lung collapse turns out to be small, the same symptoms of a collapsed lung can also occur in other serious chest emergencies.
A thoracic surgeon’s review is particularly important in recurrent pneumothorax, a persistent air leak, pneumothorax in both lungs, traumatic cases, or when a chest tube does not allow the lung to expand properly. If you have had a collapsed lung before, if you have underlying lung diseases, or if you work in a high-risk occupation, speaking with a doctor early is essential. Specialist input is also helpful for those whose work or lifestyle puts them at an increased risk of recurrence, such as pilots, cabin crew or divers. At Neumark Lung & Chest Surgery Centre, decisions about observation, chest drainage, pleurodesis, or minimally invasive surgery become more precise and individualised.
A pneumothorax is usually diagnosed with imaging, most often a chest X-ray, although some emergencies are recognised clinically before any imaging.
On a chest X-ray, doctors look for air outside the lung and signs that the lung has pulled away from the chest wall. A second chest X-ray may be taken after initial treatment to confirm that your lung has re-expanded. If the pneumothorax X-ray is unclear or if the clinical situation is more complex, a computed tomography (CT) scan can show much more detail about the air in the pleural space and the space between the lung and the chest wall. An ultrasound is also increasingly used, especially in acute care settings.
The history and examination still matter if there is no immediate emergency. Your doctor will ask about any chest injury, smoking, prior lung disease, previous episodes, recent medical procedures, and family history. A doctor may also ask about occupational exposures or lung diseases that increase the risk of a pneumothorax. A tension pneumothorax is sometimes diagnosed based on symptoms and signs alone before imaging, as treatment cannot safely wait. In more severe cases, an arterial blood gas test may also be used to check oxygen and carbon dioxide levels.
The diagnosis also includes understanding the cause. Pneumothorax causes range from ruptured blebs in an otherwise healthy person to trauma such as a rib fracture or knife wound, mechanical ventilation, COPD, pneumonia, lung cancer, endometriosis, and connective tissue disorders such as the Marfan syndrome. The cause matters because treatment options and recurrence risk vary among patients with pneumothorax.
Pneumothorax treatment without surgery is often possible when the collapse is small, symptoms are mild, and the lung is likely to re-expand safely.
Not every pneumothorax needs an operation. Some small cases are managed with observation, repeat imaging, and sometimes oxygen therapy while the body gradually reabsorbs the air into the pleural space. A pneumothorax can resolve without surgery in selected cases, but a doctor still needs to confirm that it is safe to take that approach.
When symptoms are more significant or when the pneumothorax is larger, doctors may remove the air using needle aspiration or a chest tube. A needle aspiration uses a temporary needle or catheter to evacuate air from the pleural space into the chest cavity.
A chest tube is used when a larger or more persistent air leak requires continuous drainage, and it usually requires hospital monitoring while the lung re-expands. A chest tube may also incorporate a valve device to allow air to escape from the pleural space while preventing air from re-entering the pleural cavity. In secondary spontaneous pneumothorax, a chest tube is more often needed due to the greater severity of the collapsed lung.
In some patients, a chemical pleurodesis is used to help prevent a recurrence. This involves introducing an agent, such as talc or doxycycline, into the pleural space so that the lung adheres more firmly to the chest wall, reducing the space where air can collect. Non-surgical treatment options also include managing the underlying cause, whether that is smoking-related lung damage, infection, asthma, or another condition.
Pneumothorax surgery is usually recommended when the air leak does not stop, the lung fails to re-expand, the pneumothorax recurs, or the risk of recurrence is particularly high.
Common reasons include a persistent air leak from a chest tube, failure of the lung to expand, recurrent collapsed lung, pneumothorax in both lungs, traumatic injury, or occupational reasons such as professional flying or diving. The aim is to reduce the likelihood of a collapsed lung occurring again.
At Neumark Lung & Chest Surgery Centre, surgery for a spontaneous and recurrent pneumothorax is centred on minimally invasive thoracic surgery techniques. Video-Assisted Thoracoscopic Surgery (VATS) allows the surgeon to enter the chest cavity through small incisions using a camera and long instruments. Uniportal VATS (U-VATS) uses a single small incision and is part of Neumark’s minimally invasive practice.
During the thoracoscopic surgery, the leaking bleb or bulla can be removed from the lung, and a pleural procedure such as pleurectomy or pleurodesis can be added to help prevent recurrence. This combination is especially relevant in a spontaneous pneumothorax.
Robotic-Assisted Thoracic Surgery (RATS) is a powerful tool in many chest operations, but it is not the standard first-choice operation for most pneumothorax cases. In routine pneumothorax surgery, VATS or U-VATS is usually more relevant. The procedure chosen depends on the pattern of disease, prior episodes, lung condition, and the surgeon’s judgment about which approach will most effectively stop the leak while keeping the operation as minimally invasive as possible.
Most people recover well after treatment for a pneumothorax, but recovery depends on the cause, the treatment used, and the risk of recurrence.
Many patients after a small pneumothorax improve within days, and a collapsed lung often heals within a few days to two weeks. If you have had a collapsed lung due to a secondary cause, your recovery may take longer. Patients treated with chest tubes or surgery may stay in the hospital for monitoring, oxygen therapy, pain control, and repeat imaging to confirm that the lung has fully re-expanded. Early mobilisation is helpful, but follow-up is important to confirm that the lung remains expanded.
Possible complications include a re-expansion pulmonary oedema, infection, bleeding, persistent air leak, treatment-related pain, respiratory failure, or recurrence. If you smoke, there is an increased risk of another collapsed lung, which is why smoking cessation is one of the most important parts of prevention. If you have underlying lung diseases such as COPD or emphysema, there is an increased risk of further episodes. Air travel and scuba diving should usually be avoided for a period after treatment, and the timing should be discussed with your doctor.
For life after pneumothorax, the outlook is often good, especially after full lung re-expansion and in patients without major underlying conditions. Even so, good recovery also means understanding the warning signs of recurrence, keeping follow-up appointments, and managing any underlying condition that contributed to the episode.
Neumark Lung & Chest Surgery Centre can help by assessing the cause of the pneumothorax, choosing the safest treatment, and, where possible, reducing the risk of future episodes.
Neumark Lung & Chest Surgery Centre specialises in minimally invasive thoracic surgery with a multidisciplinary approach led by Dr Harish Mithiran, senior consultant thoracic surgeon at Gleneagles and Mount Alvernia hospitals. We will review your imaging and history carefully before recommending a treatment plan.
If surgery is needed, Neumark’s approach emphasises minimally invasive techniques such as VATS and U-VATS to repair the air leak and reduce the risk of recurrence in patients with pneumothorax, while limiting surgical trauma. If surgery is not needed, the focus remains on safe drainage, recovery, follow-up imaging, and prevention of future episodes.
If you or a loved one has been diagnosed with a pneumothorax, or if you have sudden chest pain and difficulty breathing that could be a collapsed lung, contact Neumark Lung & Chest Surgery Centre for a consultation. If you have had a previous collapsed lung and are concerned about recurrence, our specialists can assess your risk and discuss your treatment options.
Many cases are spontaneous, occurring when small blebs rupture, especially in tall, thin young adults. Other common causes include chest trauma, medical procedures, smoking-related lung damage, COPD, pneumonia, and other underlying lung diseases.
A small pneumothorax may settle with monitoring, but a tension pneumothorax is life-threatening and needs immediate treatment. Any suspected collapsed lung should be assessed urgently.
Treatment may include observation, oxygen, needle aspiration, chest tube drainage, pleurodesis, or surgery. The right choice depends on the size of the collapse, symptoms, cause, and whether it has happened before.
Sometimes, yes. Small pneumothoraces can resolve on their own, but they still need medical assessment and follow-up to make sure the lung is re-expanding safely.
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Neumark Lung & Chest Surgery Centre benefits from the expertise of a multidisciplinary team led by Dr Harish Mithiran, senior consulting thoracic surgeon at Gleneagles Hospital and Mt Alvernia Hospital.
Neumark is a lung and chest specialist centre with access to leading treatment modalities to achieve the best possible outcomes for lung disease and preventative patient screening.
Our foremost priority is to treat your condition as effectively as possible. Schedule a private consultation today; complete the form below, call, +65 6908 2145; WhatsApp, +65 9726 2485; or email, info@neumarksurgery.com.
Gleneagles Medical Centre
6 Napier Road
#02-09 Gleneagles Medical Centre
Singapore 258499
Mount Alvernia Hospital
820 Thomson Road
#06-07 Medical Centre A
Singapore 574623
