Summary
Definition
History and exam
Key diagnostic factors
- chest pain
- dyspnoea
- ipsilateral reduced breath sounds
- ipsilateral hyperinflation of the hemithorax with hyper-resonance on percussion
- hypoxia
- presence of risk factors
- cardiopulmonary deterioration
- trachea shifted to the contralateral side
- sweating
Risk factors
- cigarette smoking
- family history of pneumothorax
- tall and slender body build
- age <40 years
- recent invasive medical procedure
- chest trauma
- acute severe asthma
- COPD
- tuberculosis
- AIDS-related Pneumocystis jirovecii infection
- cystic fibrosis
- lymphangioleiomyomatosis
- Marfan syndrome
- homocystinuria
- primary lung cancer and metastatic cancer to the lungs
- Birt-Hogg-Dube syndrome
- pulmonary Langerhans cell histiocytosis
- Erdheim-Chester disease
Diagnostic investigations
Treatment algorithm
Contributors
Expert advisers
Jonathan Bennett, MD
Honorary Professor of Respiratory Sciences
University of Leicester
Respiratory Consultant
Glenfield Hospital
Leicester
UK
Biography
JB is Chair of the British Thoracic Society (BTS). He is also deputy medical director RCP Invited service Reviews, and speaker at National Society (eg., BTS), Primary Care respiratory Society, Society Cardiothoracic Surgeons meetings.
Disclosures
JB declares that he has no competing interests.
Claire Vella, MD, MRCP
Clinical Fellow Lung Cancer and Interventional Pulmonology
Glenfield Hospital
Leicester
UK
Disclosures
CV declares that she has no competing interests.
Onyeka Umerah,
Respiratory Registrar
Glenfield Hospital
University Hospitals of Leicester NHS Trust
Leicester
UK
Disclosures
OU declares that she has no competing interests.
Acknowledgements,
BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:
Lonny Yarmus, DO, MBA
Associate Professor of Medicine and Oncology
Clinical Director, Division of Pulmonary and Critical Care
Director, Interventional Pulmonology Research Core
Johns Hopkins Medical Institutions
Baltimore
MD
Jason Akulian, MD, MPH
Assistant Professor of Medicine
Director, Interventional Pulmonology
Carolina Center for Pleural Disease
University of North Carolina
Chapel Hill
NC
Disclosures
LY has received research grants and consulting fees from Olympus, Inc, the manufacturer of the Spiration intrabronchial valve. JA declares that he has no competing interests.
Peer reviewers
Matthew Knight, PGCertEd MD FRCP FRCP(Edin)
Associate Postgraduate Dean
Health Education England
Royal College of Physicians College Tutor
Consultant Respiratory Physician
Watford General Hospital
West Hertfordshire Hospitals NHS Trust
Disclosures
MK was collaborator and site principal investigator for the randomised ambulatory management of primary pneumothorax (RAMPP) trial, which received funding from Rocket Medical. MK has attended meetings sponsored by Rocket Medical.
Editors
Annabel Sidwell,
Section Editor, BMJ Best Practice
Disclosures
AS declares that she has no competing interests.
Anna Ellis,
Head of Editorial, BMJ Best Practice
Disclosures
AE declares that she has no competing interests.
Rachel Wheeler,
Lead Section Editor, BMJ Best Practice
Disclosures
RW declares that she has no competing interests.
Julie Costello,
Comorbidities Editor, BMJ Best Practice
Disclosures
JC declares that she has no competing interests.
Adam Mitchell,
Drug Editor, BMJ Best Practice
Disclosures
AM declares that he has no competing interests.
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