Etiology, diagnosis and treatment of pneumothorax

Pneumotoraks (lat. Pneumothorax) je stanje prilikom kojeg zrak iz pluća ili vanjske sredine ulazi u prsnu šupljinu i izaziva kolaps pluća. Pneumotoraks prema uzroku nastanka dijelimo na: spontani, traumatski i jatrogeni. Prema trajanju može biti akutni i kronični, a prema veličini parcijalni i kompletni. Primarni spontani pneumotoraks pretežno se javlja u zdravih, mladih muškaraca, višeg rasta i asteničke kostitucije. Sekundarni spontani pneumotoraks komplikacija je prethodno klinički dokazane plućne bolesti. Traumatski pneumotoraks nastaje kao posljedica ozljede prsnog koša, a jatrogeni nastaje kao komplikacija medicinskih intervencija. Kliničkom slikom dominira dispneja i bol u prsima. Dijagnoza se postavlja na temelju kliničke slike, anamneze i fizikalnog pregleda te radioloških pretraga. Za potvrdu dijagnoze dovoljna je rtg snimka prsnog koša u uspravnom posteroanteriornom položaju. Liječenje ovisi o tipu i veličini pneumotoraksa, općem stanju pacijenta, zanimanju pacijenta te o iskustvu liječnika. Terapijske mogućnosti su: opservacija, metode aspiracije (torakocenteza, drenaža prsišta) i kirurško liječenje (torakotomija i VATS). Cilj liječenja je potpuna reekspanzija pluća i sprječavanje recidiva.Pneumothorax is a condition in which air from lungs or outside of the body enters pleural cavity and causes lung to colapse. According to the cause of occurrence, pneumothorax can be spontaneous, traumatic and iatrogenic. By duration, it can be acute or chronic, and by size: partial and complete. Primary spontaneous pneumothorax is the one that mostly occurs in healthy, young, tall and thin man. Secundary spontaneous pneumothorax is usually a complication of underlying lung disease. Traumatic pneumothorax is the consequence of chest trauma. Iatrogenic pneumothorax occurs as complication of medical interventions. Chest pain and dyspnea are the usual predominant presenting features. The diagnosis is based on a clinical presentation, anamnesis and physical examination and radiological examinations. Diagnosis can be confirmed in the majority of cases with an upright posteroanterior chest radiograph. The treatment of pneumothorax depends of type and size of pneumothorax, general condition of patient, patient's profession and on the personal preference of the doctor. Terapeutic options are: observation, aspiration (thoracocenthesis and chest tube drainage) and surgical treatment (toracotomy and VATS). The goal of treatment is complete lung reexpansion and prevention of recurrence