A pneumothorax is an abnormal collection of air in the pleural space that causes an uncoupling of the lung from the chest wall. Like a pleural effusion (liquid buildup in that space), a pneumothorax may interfere with normal breathing. Symptoms typically include chest pain and shortness of breath. It is often called a collapsed lung, although that term may also refer to atelectasis. One or both lungs may be affected. A primary pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease, while a secondary pneumothorax occurs in the presence of existing lung disease. A pneumothorax can be caused by physical trauma to the chest (including a blast injury), or as a complication of a healthcare intervention; in which case it is called a traumatic pneumothorax. In a minority of cases the amount of air in the chest increases markedly when a one-way valve is formed by an area of damaged tissue, leading to a tension pneumothorax. This condition can cause a steadily worsening oxygen shortage and low blood pressure. Unless reversed by effective treatment, it can result in death. Diagnosis of a pneumothorax by physical examination alone can be difficult (particularly in smaller pneumothoraces). A chest X-ray, computed tomography (CT) scan, or ultrasound is usually used to confirm its presence. Small spontaneous pneumothoraces typically resolve without treatment and require only monitoring. This approach may be most appropriate in people who have no underlying lung disease. In a larger pneumothorax, or when there are marked symptoms, the air may be removed with a syringe or a chest tube connected to a one-way valve system. Occasionally, surgery may be required if tube drainage is unsuccessful, or as a preventive measure, if there have been repeated episodes. The surgical treatments usually involve pleurodesis (in which the layers of pleura are induced to stick together) or pleurectomy (the surgical removal of pleural membranes).

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