Pneumothorax In Children & Young People

Key points about pneumothorax

• a pneumothorax happens when air gets trapped between the lung and chest wall
• this happens because of a small tear in the lung
• a pneumothorax often happens suddenly, without warning
• a pneumothorax can be very serious, and sometimes life-threatening
• call 111 for urgent medical help if you're worried your child has a pneumothorax

What is a pneumothorax?

A pneumothorax happens when air gets trapped between the lung and the chest wall. This occurs because a small tear in the lung means air can leak out. Trapped air around the lung can squash it or make it collapse. This can happen to part of the lung or the whole lung. People sometimes call a pneumothorax a 'collapsed lung'. A pneumothorax makes it harder to breathe.

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This illustration shows a boy with a close-up view of his lungs. Two close-up circles compare normal lungs with a pneumothorax:

• The Normal lungs are both fully expanded.
• The Pneumothorax side shows one lung collapsed with blue “trapped air” between the lung and chest wall.
• Labels point to the 'Trapped air' and 'Collapsed lung'.
• Text underneath says: 'Pneumothorax – Air trapped between the lung and the chest wall'.

At the bottom left is the KidsHealth logo with the website: kidshealth.org.nz.

Causes of pneumothorax

Spontaneous

A pneumothorax is usually spontaneous. This means it happens suddenly without a clear cause. It’s more common in tall, thin rangatahi (young people), especially boys.

Lung conditions

A pneumothorax can happen in tamariki (children) who have an underlying lung condition. This includes conditions like asthma and cystic fibrosis.

Tamariki and rangatahi with certain medical conditions have a higher risk of pneumothorax. This includes conditions such as Marfan syndrome or Ehlers-Danlos.

Injury

A pneumothorax can happen after an injury to the chest, such as a broken rib puncturing the lung.

Signs and symptoms of a pneumothorax

A child or young person with a pneumothorax may have:

• sudden sharp chest pain
• difficulty breathing
• a dizzy or lightheaded feeling
• a fast heartbeat

Diagnosing pneumothorax

Tamariki need a chest x-ray to show a pneumothorax. Some tamariki need a CT scan of their chest.

X-Rays For Children

CT Scans For Children

Managing pneumothorax

A small pneumothorax may not need any treatment and will get better on its own over a few days.

Chest drain

A large pneumothorax, with trapped air around the lung, will need a chest drain. A doctor may put a chest drain in while your child is asleep under general anesthetic. But, in an emergency, the doctor might need to put the chest drain in quickly, without putting your child to sleep.

Tamariki usually need a chest drain for 2 to 5 days until there is no more air between the lung and chest wall. 

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This illustration shows two side-by-side images of a boy’s chest. Each one shows something different related to a pneumothorax (air trapped around the lung).

• The left image is labelled 'Pneumothorax'. It shows a collapsed left lung with blue 'Trapped air' around it.
• The right image is labelled 'Chest drain'. It shows the chest wall with ribs visible and a chest drain inserted into the left side. A tube leads from the chest to a container. The label says 'Chest drain draining out the trapped air'.

The KidsHealth logo appears in the bottom left corner, with the website kidshealth.org.nz.

Surgery

If the lung doesn’t expand after the chest drain, your child may need pleurodesis. Pleurodesis is a surgery to repair a leak in the lung. It involves sticking the lung to the inside of the chest wall. 

Can pneumothorax happen again?

For most tamariki and rangatahi, this only happens once. Sometimes, a pneumothorax can come back. These tamariki and rangatahi may need pleurodesis to help stop another pneumothorax happening.

After a pneumothorax

If your child has had a pneumothorax, they can't travel by plane until they've had a chest x-ray that shows it's gone.

SCUBA diving can be very dangerous for someone who has had a pneumothorax. PADI, the diving organisation, discourages anyone who has had a pneumothorax from diving.