[Emergency Science] What is pneumothorax? Can "lungs explode" really happen?

The news of the death of the famous singer Khalil Fong has attracted widespread attention from the public. Previously, he had suffered from pneumothorax due to overwork in 2010, and his past experience of being hospitalized for treatment many times also frequently made the headlines.

What exactly is pneumothorax? What are its specific symptoms? And why is it more common in young, tall, thin men?

Be alert to chest pain and difficulty breathing. The medical term "pneumothorax" may sound unfamiliar at first, but it actually has a common name that is easy to understand - "exploded lung."

Previously, many cases of pneumothorax have attracted public attention due to unexpected onset scenarios.

A 35-year-old man in Zhengzhou, Henan, had a "lung explosion" after doing 20 push-ups in a row. Examination revealed that there was a small hole in his lung and his right lung was compressed to only one-third. After comprehensive diagnosis, it was determined to be spontaneous pneumothorax.

There are also people who sang for 4 hours straight to satisfy their "microphone master" addiction. After they finished, they suddenly felt a pain in their chest like being pricked by needles. The diagnosis results showed that it was because they sang too hard, and the high air pressure in the chest cavity ruptured the alveoli, thus causing pneumothorax.

So, what exactly is pneumothorax?

Zhang Yi, director of the Department of Thoracic Surgery at Xuanwu Hospital of Capital Medical University, said in an interview with China News Service that pneumothorax refers to the accumulation of gas in the chest cavity, which is caused by air entering the pleural cavity. It can be divided into three categories: spontaneous, traumatic and iatrogenic . What people say in daily life , "the lungs are inflated", actually refers to spontaneous pneumothorax .

In clinical work, Director Zhang Yi observed that the three most common symptoms of pneumothorax patients are chest pain, chest tightness and shortness of breath, and irritating dry cough.

Director Zhang Yi emphasized: "If the patient has cyanosis of the lips or skin, profuse sweating, severe shortness of breath, tachycardia, and hypotension, tension pneumothorax should be considered , and thoracentesis should be performed immediately to vent the air. In a small number of patients, pneumothorax compresses the lung tissue, causing the chest adhesion band to break, which in turn causes chest bleeding. In daily life, if the patient suddenly develops chest pain after coughing, sneezing, strenuous exercise, or chest trauma, accompanied by symptoms such as chest tightness, shortness of breath, and irritating dry cough, he should seek medical attention in time to determine whether he has pneumothorax."

Liang Chaoyang, director of the Department of Thoracic Surgery at the China-Japan Friendship Hospital, analyzed in an interview with China Health News: " Chest pain is the most typical symptom of pneumothorax ." He said that the pain caused by pneumothorax is mostly needle-like or dull pain. This pain can extend to the shoulders and back, and will be aggravated when the patient takes a deep breath or coughs .

Director Liang Chaoyang also mentioned: "The pain in most patients will last for a few minutes to a few hours and then subside on its own. But if the pain does not subside for more than 24 hours, you must be highly vigilant, as it may be tension pneumothorax or a combined infection ." In addition, Director Liang Chaoyang pointed out that some patients with small pneumothorax (lung compression level <20%) may not have obvious pain symptoms, and the lesions in these patients can usually only be discovered through imaging examinations such as chest X-ray or CT.

**Who does pneumothorax "favor"? **According to Lv Xuewen, director of the Department of Critical Care Medicine at the Second People's Hospital of Hunan Province, pneumothorax is particularly likely to target the following groups of people.

"Bamboo-Shaped" Teenagers : Tall and thin, especially teenage males over 180cm tall. This group of people often develop bullae at the apex of their lungs that resemble "little balloons". Even a small sprint during intense exercise or even an inadvertent sneeze can cause this "little balloon" to "explode" instantly, leading to pneumothorax.

Senior smoker : Smoking is like "poisoning" the alveoli. Every puff of smoke erodes the health of the alveoli step by step, making them extremely fragile, like a "crispy bubble" that bursts as soon as it is blown.

High-risk of recurrence : If you have had pneumothorax once, the probability of recurrence is as high as 50%. Therefore, friends who have a history of pneumothorax must pay special attention.

Special occupational groups : Divers and pilots frequently face drastic changes in air pressure during work. Under such conditions, the lungs are like an emotionally unstable child, which may suddenly "explode" or even "burst", eventually causing pneumothorax.

Zhang Yi pointed out that although the probability of death directly caused by simple pneumothorax is not high, some patients may develop complications such as hemothorax or pyopneumothorax, which may damage lung function. For those who are at high risk, they should avoid activities such as weightlifting, diving, and high-altitude flying that may cause drastic changes in chest pressure. At the same time, it is necessary to strictly quit smoking to reduce the risk of alveolar damage . It is recommended to have regular health examinations in daily life, and chest CT examinations can screen for bullae.

During the treatment phase and after recovery, patients must strictly follow the following management guidelines:

During the acute phase, patients must ensure adequate bed rest and avoid any strenuous activities that may increase chest pressure, such as weightlifting and carrying heavy objects . In addition, patients must be alert to respiratory diseases such as colds and severe coughs . When entering the recovery phase, patients can gradually carry out low-intensity exercises, but during exercise, they should avoid explosive force movements.