Pneumothorax is a collapsed lung.

Pneumothorax occurs when air leaks into the space between your lungs and chest wall. This air pushes on the outside of your lung and makes it collapse. In most cases, only a portion of the lung collapses. A pneumothorax can be caused by a blunt or penetrating chest injury, certain medical procedures involving your lungs or damage from underlying lung disease. Sometimes, pneumothorax occurs for no obvious reason. When the lung collapses, it causes sudden chest pain and shortness of breath. Signs and symptoms of a pneumothorax usually include: Chest pain. Sudden, sharp chest pain on the same side as the affected lung this pain doesn't occur in the center of your chest under the breast bone. And it doesn't worsen when you breathe in and out. Shortness of breath. This may be mild or severe, depending on how much of your lung is collapsed and whether you have underlying lung disease. TREATMENT The goal in treating a pneumothorax is to relieve the pressure on your lung, allowing it to reexpand, and to prevent recurrences. The best method for achieving this depends on the severity of the lung collapse and sometimes on your overall health. Observation If only a small portion of your lung is collapsed, your doctor may simply monitor your condition with a series of chest X-rays until the air is completely absorbed and your lung has re-expanded. This may require bed rest as any exertion may aggravate the collapse. Supplemental oxygen can speed the absorption process. Needle or chest tube insertion If a larger area of your lung has collapsed, it's likely that a needle or chest tube will be used to remove the air. The hollow needle or tube is inserted between the ribs into the air-filled space that is pressing on the collapsed lung. With the needle, a syringe is attached so the doctor can pull out the excess air just like a syringe is used to pull blood from a vein. Chest tubes are often attached to a suction device that continuously removes air from the chest cavity and may be left in place for several hours to several days. Surgery If a chest tube doesn't resolve your problem, surgery may be necessary to close the air leak. In most cases, the surgery can be performed through small incisions, using a tiny fiberoptic camera and narrow, long-handled surgical tools. The surgeon will look for the leaking bleb and sew it closed. If no leaking bleb is visible, a substance like talc is blown in through the tube to irritate the tissues around the lung so that they'll stick together and seal any leaks. Rarely, the surgeon will have to make a larger incision between the ribs to get better access to multiple or larger air leaks.

Hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity). The most common cause of hemothorax is chest trauma. It can also occur in patients who have: Blood clotting defect Chest (thoracic) or heart surgery Death of lung tissue (pulmonary infarction) Lung or pleural cancer Tear in a blood vessel when placing a central venous catheter Tuberculosis

TREATMENT The goal of treatment is to get the patient stable, stop the bleeding, and remove the blood and air in the pleural space. A chest tube is inserted through the chest wall to drain the blood and air. It is left in place for several days to re-expand the lung. When a hemothorax is severe and a chest tube alone does not control the bleeding, surgery (thoracotomy) may be needed to stop the bleeding. The cause of the hemothorax should be also treated. In people who have had an injury, chest tube drainage is often all that is needed. Surgery is often not needed. Hydrothorax is a condition that results from serous fluid accumulating in the pleural cavity. This specific condition can be related to cirrhosis with ascites in which ascitic fluid leaks into the pleural cavity. Hepatic hydrothorax is often difficult to manage in end-stage liver failure and often fails to respond to therapy. In similar pleural effusions, the fluid is blood in hemothorax (as in major chest injuries), pus in pyothorax (resulting from chest infections), and lymph in chylothorax (resulting from rupture of the thoracic duct). TREATMENT Treatment of hydrothorax is difficult for several reasons. The underlying condition needs to be corrected; however, often the source of the hydrothorax is end stage liver disease and correctable only by transplant. Chest tube placement should not occur. Other measures such as a TIPS procedure are more effective as they treat the etiology of the hydrothorax, but have complications such as worsened hepatic encephalopathy. A pleural effusion is an abnormal amount of fluid around the lung. Pleural effusions can result from many medical conditions. Most pleural effusions are not serious by themselves, but some require treatment to avoid problems. Numerous medical conditions can cause pleural effusions. Some of the more common causes are: Congestive heart failure Pneumonia Liver disease (cirrhosis) End-stage renal disease Nephrotic syndrome Cancer Pulmonary embolism Lupus and other autoimmune conditions Pleural effusions often cause no symptoms. Symptoms are more likely when a pleural effusion is moderate or large-sized, or if inflammation is present. Symptoms of pleural effusions may include: Shortness of breath Chest pain, especially on breathing in deeply (pleurisy, or pleuritic pain) Fever Cough TREATMENT Treatment for pleural effusions may often simply mean treating the medical condition causing the pleural effusion. Examples include giving antibiotics for pneumonia, or diuretics for congestive heart failure.

Large, infected, or inflamed pleural effusions often require drainage to improve symptoms and prevent complications. Various procedures may be used to treat pleural effusions, including: Thoracentesis (described above) can remove large amounts of fluid, effectively treating many pleural effusions. Tube thoracotomy (chest tube): A small incision is made in the chest wall, and a plastic tube is inserted into the pleural space. Chest tubes are attached to suction and are often kept in place for several days. Pleurodesis: An irritating substance (such as talc or doxycycline) is injected through a chest tube, into the pleural space. The substance inflames the pleura and chest wall, which then bind tightly to each other as they heal. Pleurodesis can prevent pleural effusions from recurring, in many cases. Pleural drain: For pleural effusions that repeatedly recur, a long-term catheter can be inserted through the skin into the pleural space. A person with a pleural catheter can drain the pleural effusion periodically at home. Pleural decortication: Surgeons can operate inside the pleural space, removing potentially dangerous inflammation and unhealthy tissue. Decortication may be performed using small incisions (thoracoscopy) or a large one (thoracotomy).