Pneumothorax in children

A pneumothorax happens when air leaks out of the lung. This page has information on pneumothorax in children.

We also have information on pneumothorax in adults.


What is a pneumothorax? 

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.


What causes a pneumothorax in children?

There are many causes of a pneumothorax. The most common causes are listed below.

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.


Causes of pneumothorax in babies

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.


What are the signs and symptoms of a pneumothorax? 

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.

Find out more about the signs of breathing problems in children and when to seek urgent medical help.


How is it diagnosed?

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.


How is it treated? 

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.


How long will it take for my child to recover?

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.


Useful resources

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.

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Last medically reviewed: September 2019. Due for review: September 2022

This information uses the best available medical evidence and was produced with the support of people living with lung conditions. Find out how we produce our information. If you’d like to see our references get in touch.