Last reviewed: 21 Aug 2021
Last updated: 09 Aug 2021

Summary

Definition

History and exam

Key diagnostic factors

  • chest pain
  • dyspnea
  • hyperexpanded ipsilateral hemithorax
  • hyper-resonant ipsilateral hemithorax
  • ipsilateral absent or diminished breath sounds
  • extreme breathlessness
  • trachea shifted to contralateral side

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

Authors

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

Disclosures

LY declares that he has no competing interests.

Jason Akulian, MD, MPH

Assistant Professor of Medicine

Director, Interventional Pulmonology

Carolina Center for Pleural Disease

University of North Carolina

Chapel Hill

NC

Disclosures

JA declares that he has no competing interests.

Acknowledgements

Dr Lonny Yarmus and Dr Jason Akulian would like to gratefully acknowledge Dr Ryland P. Byrd Jr, Dr Thomas M. Roy, and Dr Anita Alwani, previous contributors to this topic.

Disclosures

RPB, TMR, and AA declare that they have no competing interests.

Peer reviewers

Marc Noppen, MD

Professor and Chief Executive Officer of Respiratory Division

Interventional Endoscopy Clinic

University Hospital Brussels

Brussels

Belgium

Disclosures

MN declares that he has no competing interests.

Steve A. Sahn, MD

Professor of Medicine

Division of Pulmonary Critical Care, Allergy and Sleep Medicine

Medical University of South Carolina

Charleston

SC

Disclosures

SAS declares that he has no competing interests.

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