Pneumothorax in children
- What is a pneumothorax?
- What causes it?
- What are the symptoms of pneumothorax in children?
- How is it diagnosed?
- How is it treated?
- How long will it take for my child to recover?
We also have information on pneumothorax in adults.
A pneumothorax happens when air leaks out of the lung. It becomes trapped in the space between the outside of the lung and the ribcage. The air can squash the lung and cause some or all of the lung to collapse.
Pneumothorax comes from two Greek words:
pneumo – air
thorax - chest.
If there is only a small amount of air and the pneumothorax is small, it can get better with time. If there is a large amount of air it can make it hard for your child to breathe and it needs urgent treatment.
The pleural space
The outside of the lungs and the inside of the ribs are each covered by a thin membrane lining. Normally, these surfaces are in very close contact with a small amount of fluid in the space. This fluid acts as a lubricant, allowing the lung to expand and contract during breathing. A pneumothorax occurs when air gets into this space between the lung and the inside of the ribs.
There are many causes of a pneumothorax. The most common causes are listed below.
My rare lung condition caused a buzz in hospital
Out of the blue, Holly had a pneumothorax when she was 18.
Primary spontaneous pneumothorax
Sometimes the air leak may happen suddenly, for no apparent reason in an otherwise healthy child. This is called primary spontaneous pneumothorax and it happens most often in older teenagers, especially tall, thin boys.
In a primary spontaneous pneumothorax, a small tear forms on the outer part of the lung. It’s not always clear why this happens, but it’s probably due to an area of weakness when the lung is developing, like a small blister.
Secondary spontaneous pneumothorax
An existing lung condition can weaken the surface of the lung and make it more likely to tear. Conditions that can cause a secondary spontaneous pneumothorax include:
Injury or trauma
An air leak can happen when the surface of the lung is damaged due to injury or trauma. For example, it may be caused by a chest injury in a car crash.
Our son was hooked up to machines
Ian and Sairah’s son had a pneumothorax at birth. This is also known as collapsed lung and is rare.
In babies, an air leak can also happen if:
- they have breathing problems, such as respiratory distress syndrome (RDS)
- they have breathed in meconium (the baby’s first poo) before they are born. This can get into the lungs and damage them
- they are premature and their lung tissue is fragile.
Pneumothorax in babies often happens in the first 24-36 days after birth.
The main symptoms of a pneumothorax are chest pain and breathlessness. They may be quite mild.
Pneumothorax symptoms in older children
In an older child, the signs and symptoms of pneumothorax often come on suddenly, usually when the child is not doing anything particular. Look out for:
- sudden, sharp stabbing pain on one side of the chest that gets worse with breathing in and out
- feeling breathless.
If someone becomes breathless with sudden chest pain, dial 999.
In older children and adolescents, pneumothorax is usually diagnosed by a chest X-ray. Your doctor will also watch your child’s chest movement and listen to their breathing.
In babies, a special light probe is shone onto the baby’s chest. If there is an air leak, the light is brighter in that area. This test is quicker and easier to carry out than an X-ray, so it’s useful in an emergency. Your child may also have a chest X-ray to confirm the diagnosis.
Treatment for a pneumothorax will depend on
- how big the air leak is
- whether it is expanding and
- what caused it
The air in your child’s chest may be removed using a needle or a chest drain.
What is a chest drain?
A chest drain is a flexible plastic tube. It’s inserted through the chest wall, after the area is numbed. The drain allows air out but not back in, so your child’s lung can re-inflate.
They may also need to be given extra oxygen.
Most children recover from a pneumothorax within a few days. They may have follow-up appointments and chest X-rays.
Will it happen again?
For children who have a spontaneous pneumothorax, there is a risk that it may happen again. This seems to happen more in children than in adults.
If a pneumothorax happens more than once on the same side, your child might have a small operation to seal the weak areas on the edge of the lung where the air leaks are happening, to make sure it cannot happen again.
We have information on pneumothorax in adults.
For more information on chest drains and how they’re used for pneumothorax in children, see the GOSH website.