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    Pneumothorax (Lung Collapse Puncture)
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    Pneumothorax (Lung Collapse Puncture)

    Last Updated 14 March 2026
    Ingredients

    Pneumothorax is a condition in which the lung is partially or completely deflated as a result of the accumulation of air in the area between the lung and the chest wall, called the pleural space.

    Under normal conditions, the negative pressure balance that keeps the lungs inflated in the rib cage is disrupted by air leakage into this cavity and the lung tissue collapses on itself like a balloon deflating.

    This condition, popularly known as “lung collapse” or “lung puncture”, is a non-oncological thoracic surgery problem that suddenly reduces respiratory capacity and requires rapid medical intervention.

    What is Pneumothorax? Lung Collapse and Perforation

    Pneumothorax is the shrinkage of the lung and loss of function due to air entering between the lung membranes (pleura).

    A microscopic hole in the outer surface of the lung or an injury to the chest wall can trigger this process.

    As the amount of extinction increases, the respiratory function on the side of the deflated lung comes to a standstill, causing oxygen levels in the body to drop rapidly.

    What Causes Pneumothorax?

    Lung collapse can develop without an underlying cause, or it can occur due to an existing disease or external factors.

    Physicians examine pneumothorax in the main categories according to the mechanism of its formation:

    Primary Spontaneous Pneumothorax (Occurring Without Cause)

    It occurs when small, thin-walled air sacs called “blebs”, usually located at the very top of the lung, burst.

    It is the most common type in individuals who do not have any lung disease, usually young (between the ages of 20-40), thin and tall.

    Smoking directly increases the formation of these vesicles and the risk of bursting.

    It develops as a result of the loss of integrity of tissues damaged by an existing lung disease.

    Conditions such as COPD, emphysema, cystic fibrosis, tuberculosis, or lung cancer weaken the lung tissue, making it susceptible to perforation.

    Since lung reserve is already limited in this group of patients, even a small deflation can lead to very severe symptoms.

    Traumatic Pneumothorax (Accidents and Injuries)

    It occurs when the lung is damaged as a result of physical blows to the rib cage.

    Traffic accidents, falls from a height, sharp tool injuries or rib fractures tearing lung tissue fall into this category.

    Sometimes unintentional complications during medical procedures (biopsy, catheter insertion, etc.) are also considered in this group.

    Tension Pneumothorax (Emergency)

    It is the most dangerous form of pneumothorax and requires immediate attention.

    A “one-way valve” mechanism is formed, in which the air entering the chest cavity cannot get out.

    The accumulated air not only deflates the lung, but can push the heart and large vessels to the opposite side, causing blood circulation to stop; This condition requires intervention within minutes.

    What are the Symptoms of Pneumothorax?

    Lung collapse usually starts suddenly and symptoms differ according to the degree of collapse.

    The body usually expresses pressure on the lung parenchyma with the following signals:

    • Sudden and Severe Chest Pain: It is usually stinging, exacerbated by breathing and can spread to the shoulder/back area.
    • Shortness of Breath: It develops due to the decrease in oxygen capacity with the collapse of the lung.
    • Dry Cough: It is a reflex condition that occurs as a result of stimulation of the airways.
    • Rapid Heartbeat (Tachycardia): It is an effort of the body to balance the decreasing oxygen.
    • Bruising on the Skin (Cyanosis): It is seen in advanced cases where the blood oxygen level drops to a critical level.

    Prof. Dr. Levent Alpay: In young patients, a stinging chest pain that develops suddenly while doing sports or at rest is often confused with muscle pain; However, if the pain is accompanied by shortness of breath, the possibility of pneumothorax should be evaluated with a chest X-ray.

    Who Is More Common in Lung Collapse? Risk Factors

    While pneumothorax can occur in any age group, certain physical characteristics and lifestyle habits significantly increase this risk.

    In particular, there is a typical patient profile of the condition we call primary spontaneous pneumothorax.

    • Gender and Body Structure: The incidence is much higher in young (20-40 years), tall and thin men than in women.
    • Smoking: Tobacco products disrupt the structure of the air sacs in the lungs, making them ready to burst; The risk is 20 times higher in smokers.
    • Genetic Predisposition: Individuals with a family history of lung collapse have an increased risk due to connective tissue weakness.
    • Existing Lung Diseases: Chronic problems such as COPD, emphysema, or cystic fibrosis weaken tissue integrity.
    • Atmospheric Variations: Although very rare, sudden pressure changes (such as diving or air travel) can trigger the rupture of risky vesicles.

    Pneumothorax Diagnosis and Diagnostic Methods

    The diagnostic process is based on the verification of the patient’s complaints and physical findings with radiological images.

    Physical Examination and Listening Findings

    When the physician listens to the lungs with a stethoscope, he determines that the respiratory sounds decrease or disappear completely on the deflated side.

    In addition, when the rib cage is tapped (percussion), a more “timbre” sound than normal due to the excess air inside is a strong finding supporting the diagnosis.

    Chest X-ray and Computed Tomography (CT)

    Chest X-ray is the first and fastest method used to detect extinction; The line where the lung tissue separates from the chest wall is clearly observed.

    Computed Tomography (CT) is the gold standard for detecting small amounts of deflation and determining the risk of recurrence by imaging the sacs called “blebs” in the upper parts of the lung.

    Pneumothorax Treatment Methods

    The main goal of treatment is to evacuate the air from the pleural space, allowing the lung to adhere to the chest wall again and reach its normal width.

    Observation and Oxygen Therapy

    If the amount of deflation is very small (below 15%) and the patient does not complain of shortness of breath, close follow-up can be applied in the hospital or at home.

    The high-flow oxygen support given to the patient helps the body absorb the air between the lung membranes faster.

    Needle Aspiration and Chest Tube Insertion (Thoracic Tube)

    If the amount of deflation is greater, the accumulated air is evacuated with the help of a needle or a thin catheter.

    In more advanced cases, “Chest Tube” (Thoracic Tube) is applied; A tube inserted through the chest wall is connected to the underwater drainage system, ensuring continuous evacuation of air inside.

    Closed Pneumothorax Surgery (Lung Patching with VATS)

    The definitive solution for recurrent lung collapse or in cases that do not heal the first time is closed surgery.

    With the VATS method, burst air sacs (blebs) are removed through a small incision and the lung surface is repaired.

    Pneumothorax Treatment Methods Comparison Table

    MethodApplication RequirementSuccess/Relapse RateHospital Stay
    ObservationVery small extinction30-50% Risk of recurrence1 – 2 Days
    Chest TubeMedium/Large extinction20-30% Risk of recurrence3 – 5 Days
    Closed Surgery (VATS)Recurrent cases1-5% Risk of recurrence2 – 3 Days

    Pleurodesis (Bonding Treatment)

    It is the process of administering special medical substances (talp or blood) between the two membranes to ensure that the lung adheres to the chest wall and prevents it from deflating again.

    This procedure can also be performed during surgery or through a chest tube.

    Prof. Dr. Levent Alpay: In the treatment of pneumothorax, it is sometimes not enough to just evacuate the air; If the risk of recurrence is high or the patient’s profession (pilot, diver) carries a risk, it is safest to solve the problem permanently with closed surgery in the early period.

    Recovery Process After Pneumothorax Surgery

    After closed surgery, patients are usually discharged within 48 hours.

    Heavy lifting, severe coughing and playing wind instruments should be avoided for the first few weeks.

    Breathing exercises (triflo) should be practiced regularly to increase lung capacity.

    Clinical Experience and Case Example (Anonymous):

    A 22-year-old smoking and tall college student presented with sudden back pain. In the X-ray, it was seen that the right lung was deflated by 40% and a thoracic tube was inserted. However, since the deflation recurred 1 week after the tube was removed, the patient underwent closed surgery with VATS. The patient, who is in his 2nd year after surgery, quit smoking and continues his active sports life without any problems.

    If you are experiencing symptoms of lung collapse or need detailed information about the treatment process, you can make an appointment with our clinic and seek professional expert opinion.

    Frequently Asked Questions

    Does Lung Collapse Resolve on Its Own?

    Only very small (millimetric) extinctions can resolve on their own with rest and oxygen supplementation; However, medium and large extinctions require surgical intervention.

    Does Pneumothorax Recur?

    In cases treated only with a chest tube, there is a 30-40% risk of recurrence within the first year; In cases where surgical repair is performed, this risk decreases to less than 5%.

    Can a Person with Lung Collapse Get on a Plan?

    A person who has had a pneumothorax attack should not board the plane until at least 2-4 weeks after the treatment is completed and full recovery is proven radiologically.

    Scientific Bibliography

    Medically Reviewed For informational purposes only

    Prof. Dr. Levent Alpay

    Prof. Dr. Levent Alpay

    As a Thoracic Surgeon, he continues his scientific studies and clinical practices on lung cancer surgery, robotic surgery and minimally invasive methods at Medicana Ataköy Hospital.