Recurring Pneumothorax: Symptoms, Risks, and Surgical Options

Q: Recurring Pneumothorax: Symptoms, Risks, and Surgical Options

To Eric： Pneumothorax in young individuals typically occurs only once, but some may experience recurrent episodes. <br>Generally speaking, among patients who have had two or more occurrences, at least one-third will have another episode, indicating the presence of additional smal

Recurrent pneumothorax

Hello Dr.
Chang,
I previously experienced a pneumothorax that took eight days to heal on its own.
After resting at home for two weeks, I had another episode yesterday, both occurring in the right thoracic cavity.
Is it unusual to have two pneumothorax events just two weeks apart? Yesterday, I went to the hospital for an X-ray, and the results showed that the extent of the collapse was similar both times, not exceeding 20%, so no chest tube was needed.
There were no coughing symptoms yesterday (or during the last episode), but this morning I had a slight cough.
Does this mean the extent of the collapse has increased, or is coughing a normal symptom of pneumothorax? Since I did not have this symptom last time, it makes me a bit anxious.
I have been considering surgery for a permanent solution; will surgery prevent future occurrences?
Thank you for addressing my concerns.
Wishing you peace and joy.
Eric

Eric, 20~29 year old female. Ask Date: 2004/09/08

Dr. Zhang Zhengda reply Pulmonology

To Eric: Pneumothorax in young individuals typically occurs only once, but some may experience recurrent episodes.
Generally speaking, among patients who have had two or more occurrences, at least one-third will have another episode, indicating the presence of additional small blebs.
For those with recurrent pneumothorax, surgery is recommended.
No one can predict whether the next episode will be mild or result in a significant pneumothorax.
For a permanent solution, surgical intervention to remove the remaining small blebs on the pleura should be considered.
Best wishes, Dr.
Chang Cheng-Ta.

Reply Date: 2004/09/08

More Info

Hello Eric,
Thank you for reaching out with your concerns regarding recurrent pneumothorax. It’s understandable to feel anxious after experiencing multiple episodes in such a short time frame. Let’s break down your questions and provide some clarity on the symptoms, risks, and surgical options related to pneumothorax.

Understanding Pneumothorax
A pneumothorax occurs when air enters the pleural space, leading to a collapse of the lung on the affected side. This can happen spontaneously, particularly in individuals with certain risk factors, such as tall, thin males or those with underlying lung conditions. The fact that you’ve experienced two episodes in quick succession may indicate an underlying issue that needs to be addressed.

Symptoms and Risks
The symptoms of pneumothorax can vary, but common signs include sudden chest pain and shortness of breath. In your case, the absence of cough during the initial episodes is not unusual, as cough is not a primary symptom of pneumothorax. However, the development of a cough after your recent episode could be related to irritation in the airways or a sign of a potential complication, such as an expanding pneumothorax. It’s essential to monitor this symptom closely, especially if it worsens or is accompanied by increased shortness of breath or chest pain.

Surgical Options
Regarding surgical intervention, there are several procedures available for recurrent pneumothorax, particularly if it is determined that you have a persistent issue that is likely to recur. The most common surgical options include:
1. Video-Assisted Thoracoscopic Surgery (VATS): This minimally invasive procedure allows the surgeon to inspect the pleural space and perform interventions, such as pleurodesis, which involves the application of a substance to adhere the lung to the chest wall, preventing future collapses.

2. Open Thoracotomy: In more severe cases or when VATS is not feasible, an open surgical approach may be necessary.

3. Pleurodesis: This can be performed during either VATS or open thoracotomy, and it aims to prevent future pneumothorax by causing the pleura to stick together.

While surgery can significantly reduce the risk of future pneumothorax, it is essential to understand that no procedure can guarantee that pneumothorax will never occur again. However, the success rates for these surgeries are generally high, and many patients experience relief from recurrent episodes.

Post-Surgical Considerations
After surgery, you will likely need to follow up with your healthcare provider to monitor your recovery and ensure that your lung is healing properly. It’s also crucial to avoid activities that could increase the risk of pneumothorax, such as scuba diving or flying, until cleared by your doctor.

Conclusion
In summary, experiencing two pneumothorax episodes within a short period is concerning and warrants further evaluation. The presence of a cough could indicate a change in your condition, and I recommend discussing this with your healthcare provider as soon as possible. If you are considering surgery, it is essential to have a thorough discussion with your surgeon about the risks, benefits, and likelihood of recurrence post-surgery.

Please keep a close eye on your symptoms, and do not hesitate to seek medical attention if you experience any worsening of your condition. Wishing you a smooth recovery and peace of mind.

Best regards,
Doctor Q&A Teams

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