Patients are usually asymptomatic 3.
Acute bronchial obstruction for any reason, such as bronchogenic carcinomas, mucus plugs, foreign bodies, or malpositioned endotracheal tubes, can cause acute lobar collapse and a marked increase in negative intrapleural pressure around the collapsed lobe which results in gas being drawn into the pleural space around the collapsed lobe while the seal between the visceral and parietal pleura remains intact.
It is also seen following removal of a pleural effusion by thoracocentesis, when the collapsed lung struggles to re-expand. It is thought that this type of ex vacuo pneumothorax occurs because (a) co-existing pleural disease precludes normal re-expansion of the lung (b) pulmonary surfactant is insufficient 4.
See article on pneumothorax. Also maybe signs of lung collapse.
Treatment and prognosis
The pneumothorax spontaneously resolves when the bronchial obstruction is relieved and the lobe re-expands. Treatment is alleviation of the obstruction and chest drain insertion is not usually required.
- 1. Berdon WE, Dee GJ, Abramson SJ et-al. Localized pneumothorax adjacent to a collapsed lobe: a sign of bronchial obstruction. Radiology. 1984;150 (3): 691-4. doi:10.1148/radiology.150.3.6695068 - Pubmed citation
- 2. Woodring JH, Baker MD, Stark P. Pneumothorax ex vacuo. Chest. 1996;110 (4): 1102-5. Pubmed citation
- 3. Panigrahi MK, Pradhan G. Pneumothorax Ex Vacuo Following Chemotherapy for Malignant Pleural Effusion. (2016) Journal of clinical and diagnostic research : JCDR. 10 (8): OJ03-4. doi:10.7860/JCDR/2016/20587.8297 - Pubmed
- 4. Staes W, Funaki B. "Ex vacuo" pneumothorax. (2009) Seminars in interventional radiology. 26 (1): 82-5. doi:10.1055/s-0029-1208386 - Pubmed