For a person to understand how a punctured lung occurs, it helps to learn more about the anatomy of the lung.
There are two layers of protective tissue called the visceral and parietal pleura that surround the lung. The space between the two layers is called the pleural cavity or pleural space.
When air collects in the pleural space, it is called a punctured lung.
- The medical term for a punctured lung is a pneumothorax.
- There are different causes and types of punctured lungs.
- In some people, a punctured lung happens spontaneously.
How does a punctured lung occur?
A punctured lung, which can cause a lung to collapse, may be caused by a violent injury.
If air collects in the pleural space outside of the lung, it has nowhere else to go.
The air puts pressure on the lung, preventing proper expansion and causing it to collapse.
The size of a pneumothorax can vary with only a small portion of the lung collapsing in some cases.
What are the causes?
A punctured lung can occur due to a violent injury, such as a knife wound or gunshot to the chest.
The condition can also develop as a complication from being on a mechanical ventilator.
More commonly, a spontaneous punctured lung occurs in people who have an underlying lung disease.
It is called a secondary spontaneous pneumothorax when it occurs in people with lung disease.
A punctured lung in someone without lung disease is called a primary spontaneous pneumothorax.
The symptoms of a punctured lung can vary. Usually, the greater the portion of the lung that has collapsed, the worse the symptoms are.
Typical symptoms include:
- Shortness of breath: Because the lung may not fully expand, breathing problems are usual.
- Chest pain: The lung itself has few pain receptors. Chest pain due to a punctured lung occurs from irritation of the tissue lining the lung. The pain is often described as sharp.
- Shoulder pain: Pain may radiate to the shoulder and back and is often made worse with coughing.
- Decreased sounds of breath: Because the lung is not expanding properly, air cannot be heard going in and out of the lungs on the affected side.
- Bluish skin color: The skin can develop a bluish tinge from a lack of oxygen reaching the organs and extremities.
- Increased heart rate: A punctured lung may lead to lower oxygen levels in the body, which can affect heart function and lead to an increased heart rate.
- Lightheadedness: If blood oxygen level decreases, it can cause a person to feel lightheaded.
Signs of a punctured lung can also be seen on a chest X-ray, where black areas of air between the lung and chest wall will be visible.
Treatment for a punctured lung
When there are no symptoms, a doctor may monitor the lungs with repeated X-rays.
What treatment is needed depends on the severity of the condition and if a person is experiencing problems.
When there are no symptoms
In instances where only a small portion of the lung has collapsed, and the pneumothorax is considered limited, treatment may not be needed. The excess air in the pleural space is reabsorbed and the lung re-expands unaided.
If no treatment is needed, the doctor usually monitors the lung with repeated chest X-rays to make sure the condition has resolved.
Some people who have decreased oxygen levels due to a punctured lung may need supplemental oxygen until their lung re-expands fully.
When there are symptoms
When symptoms, such as breathlessness, are present or a large portion of the lung has collapsed, treatment is needed.
Treatment for a pneumothorax involves lessening pressure on the affected lung to allow it to re-expand.
The most common and effective way of dealing with a punctured lung is by the insertion of a chest tube or hollow needle.
For this procedure, the doctor inserts a hollow needle or chest tube into the pleural space to let the air out. A syringe is attached to the needle to draw the excess air out of the space.
A chest tube is made of plastic and inserted into the body, in a similar way to a needle, to remove the air. The chest tube can be connected to a suction machine to remove the excess air from the pleural cavity.
If a large portion of the lung has collapsed, the chest tube may have to stay in place for a few days.
As the air comes out, the pressure against the lung is decreased and the lung tissue can expand again.
Additional procedures may be required if all the air cannot be removed or further air enters the pleural space.
The time it takes to recover from a punctured lung will vary. Recovery time is determined by the extent of the pneumothorax and the treatment that is needed. In general, recovery will take a few weeks.
During the recovery time, a person may be monitored to make sure their lungs are working properly.
People recovering from a punctured lung may be instructed to do breathing exercises to encourage full lung expansion.
It is best to talk to a doctor to determine how often and for how long breathing exercises should be done.
Although a punctured lung can be serious, it is not usually a fatal condition.
The outlook for someone with a punctured lung often depends on the cause, but treatment is usually effective. Once a punctured lung has healed, it does not typically cause adverse health effects.
Many people with a punctured lung may develop another one at some point. According to research, about 35 percent of people who have a punctured lung have a recurrence.
Since some punctured lungs occur spontaneously without a specific cause, it can be difficult to prevent the condition in all cases.
But cigarette smoking may increase a person's risk of a recurrence if they have already had a pneumothorax. A small study of 115 people indicated that smoking had a significant effect on developing another spontaneous punctured lung.