A punctured lung, also known as a collapsed lung or pneumothorax, can be a life-threatening condition. Recognizing symptoms and knowing when to seek medical attention is extremely important. Treatment, ranging from observation to surgery, will depend on the size of the puncture.
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Understanding the structure of your lungs and the protective membrane that surrounds them can help with understanding what having a punctured lung means.
According to the National Heart, Lung, and Blood Institute, your lungs are surrounded by a protective double-layered membrane called the pleura. Think of the pleura as the buffer zone between your lungs and your rib cage.
A punctured lung occurs when air or gas accumulates inside of the pleural cavity for one reason or another, states the National Center for Biotechnology Information (NCBI). The type of punctured lung that someone experiences may differ from someone else's based on the cause and the complexity.
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What Causes a Lung Puncture
A punctured lung can have many different causes, according to the NCBI. Causes are grouped in the following categories:
Traumatic. Most punctured lungs are caused by some type of blunt trauma or serious injury to the chest. When a traumatic injury happens during a medical procedure, it's called an iatrogenic pneumothorax.
Spontaneous. Sometimes a puncture in the lung occurs for no apparent reason or obvious cause. This type of punctured lung is more common in tall, thin men who smoke. A person who experiences a primary spontaneous punctured lung has a 20 to 60 percent chance of having another within the next three years.
It's important to note that while the average person has about a 0.1 percent lifetime risk of a non-traumatic punctured lung, the risk is 12 percent among smokers. There's also a type called a secondary spontaneous puncture that can occur in someone with an underlying lung disease.
Catamenial. This is a rare cause that occurs in women. Although the exact cause isn't clear, one theory is that it is related to the growth of endometrial tissue outside of the uterus into the diaphragm or space between the chest cavity wall and the lungs, according to the National Association of Rare Disorders.
A punctured lung can also vary in severity, says NCBI.
- When you have a "simple" punctured lung, air stays within the pleural space. This is the type that typically results from a fractured rib.
- When you have a "communicating" punctured lung, there is communication between the air inside and outside of the pleural space. This often happens as a result of a severe trauma that compromises the chest wall, such as a gunshot wound.
- When you have a "tension" punctured lung, the air stays inside the pleural space, but accumulates and is unable to escape. This can lead to pressure on the vena cava (a large vein that returns blood to the heart) and other key blood vessels and ultimately can affect your heart's output.
A punctured lung should be painful, right? As amazing as it sounds, it is possible to have a punctured lung and have no noticeable symptoms at all, says NCBI. Sometimes a punctured lung is found by accident, during an examination for another condition.
However, when there are symptoms that can alert you to a punctured lung, they're likely to be difficulty breathing and severe chest pain, adds NCBI. Skin discoloration, anxiety and coughing are other possible symptoms.
If you or someone else experiences these symptoms, especially if the symptoms get worse over time, you should seek medical attention, advises Robert Y. Goldberg, MD, a pulmonologist with Mission Hospital in Mission Viejo, California. "Pneumothorax can become a life-threatening situation in a short period of time," he cautions.
Treating a Punctured Lung
The treatment you need depends on the type and cause of your punctured lung. "Small pneumothoraxes can be treated with observation, but larger pneumothoraxes might need to be treated with chest tubes — tubes placed in the space between the chest wall and the lungs," says Dr. Goldberg.
In all cases, it's better to seek medical attention than to wait and see if the issue will resolve on its own. Sometimes, says NCBi, undiagnosed and untreated pneumothorax can result in death.
- Robert Y. Goldberg, MD, pulmonologist, Mission Hospital, Mission Viejo, California
- National Center for Biotechnology Information: “Acute Pneumothorax Evaluation and Treatment”
- National Heart, Lung, and Blood Institute: “How Lungs Works”
- National Organization for Rare Diseases: "Catamenial Pneumothorax"