Punctured Lung: Symptoms, Treatments, and Recovery

Jan 31, 2022

When you think of the potential injuries you can suffer due to a car accident, things like whiplash or a concussion may come to mind first. While these are common, there is a wide range of possible car accident injuries you may not think about. For example, a punctured lung or collapsed lung can occur as a result of a car accident and have severe consequences. Read on to learn more about this injury and what it means.

What Is a Punctured Lung?

A punctured lung, also known as a collapsed lung or a pneumothorax injury, occurs when air enters the space between the lung and the chest wall. This air presses on the outside of your lung, causing it to collapse in full or in a portion. The lung can then not expand properly, preventing oxygen from entering the bloodstream efficiently.

Depending on the cause of a punctured lung, it may be categorized in one of three ways:

Traumatic pneumothorax: A direct trauma to the chest, like a broken rib or an injury from a stab wound or gunshot, causes this type of pneumothorax. There are also medical procedures that deliberately collapse the lung in a controlled environment, which would also be considered this form of the condition.

Primary spontaneous pneumothorax: This occurs when the punctured lung happens without an exact known cause. It commonly is a result of a rupture in a small air sac on the outside of the lung, which allows air to leak into the surrounding cavity.

Secondary spontaneous pneumothorax: When a punctured lung is caused by a pre-existing lung disease, it is classified this way. Common conditions that induce a collapse may include cancer, asthma, or chronic obstructive pulmonary disease (COPD).

Causes of Punctured Lungs

While it is not always clear what caused a punctured lung, there are a number of known causes.
A chest injury can cause a lung to collapse, including a car accident. The impact itself of blunt force to the chest can be a factor, or a broken rib may puncture the lung. Other physical assaults, use of weapons, and sports injuries can have similar outcomes. It is also possible for a medical procedure to purposefully or accidentally cause a puncture, such as during the insertion of a needle into the chest.

Damaged lungs are more likely to collapse. Underlying diseases like pneumonia or cystic fibrosis are, therefore, potential causes. Cystic lung diseases, like Birt-Hogg-Dube syndrome, can cause round, thin-walled air sacs in the lung tissue to rupture and cause pneumothorax. People who need mechanical assistance to breathe can also experience an imbalance of air pressure within the chest that causes the lungs to collapse completely.

Ruptured air blisters can also be a cause when small air blisters known as blebs develop on the top of the lungs. When they burst, air leaks into the space surrounding the lungs and causes a collapse.

In general, men are more likely to suffer a pneumothorax than women. People between 20 and 40 are the most likely to have an incident caused by ruptured air blisters, especially when they are tall or underweight. Other risk factors can include genetic predisposition, previous pneumothorax, and smoking cigarettes.

Symptoms of a Collapsed Lung

It is critical to identify a collapsed lung as soon as possible to seek early treatment and avoid the injury becoming life-threatening. If you have experienced any trauma to the chest or have existing lung conditions, look for these signs:

  • Chest pain that worsens with coughing or breathing deeply
  • Shortness of breath
  • Abnormalities in breathing patterns
  • Tightness in the chest
  • A rapid heart rate
  • Pale or blue skin (due to reduced oxygen)
  • Fatigue

A punctured lung may cause soreness in the chest, usually on one side, as only one lung is usually affected.

If tension pneumothorax is present, you may experience signs of cardiovascular collapse and should treat this as a life-threatening emergency. In this case, large veins in the neck may stick out, the pulse may be rapid, and blood pressure may be low. Anxiety and difficulty speaking are also common. If untreated for more than several minutes, loss of consciousness, shock, and death can occur.

Diagnosis of a Punctured Lung

If it is suspected that you have suffered from a punctured lung, your doctor will first specifically listen to your chest using a stethoscope. They may tap your chest while you breathe in order to listen for hollow sounds. They may also suggest an arterial gas test to assess if you are experiencing high levels of carbon dioxide and low levels of oxygen, which can indicate a problem.

In order to get a definite diagnosis, you will need to undergo imaging like an x-ray, an ultrasound, or a CT scan. Very small cases can be missed on a routine chest x-ray, and a doctor may take multiple films, including x-rays in full expiration to ensure they identify any signs of a collapsed lung.

Treatment Options

The treatment for a punctured lung will vary based on the severity of the trauma, cause of the condition, and amount of damage to the lung. The goal is to reduce pressure on the lung and allow it to re-inflate.

In the case of a small pneumothorax, it may heal on its own under the supervision of your doctor. Oxygen and rest are often prescribed as the primary treatment in these cases, or a doctor may release additional air by sucking it out through a needle and allowing the chest to expand fully. If this isn’t performed, the excess air can be re-absorbed over time. Repeated x-rays are used to monitor the condition and ensure it has resolved.

When the pneumothorax is larger and requires intervention, a chest tube is placed through the ribs and into the area around the lungs to help drain the air. This tube may be left in place for both drainage and to help inflate the lung. Severe cases may require the tube to be left in for several days before the chest begins to expand.

To prevent a future collapse, a doctor may also perform chemical pleurodesis, in which chemicals are sent through the tube that help the lung attach to the chest cavity and eliminate extra space.

If the air is not removed by the tube or a patient suffers from repeated punctured lungs, surgery would be the next step. Large puncture wounds may also require surgery if the lung tissue cannot close immediately and repair itself. These repairs would be done by a surgeon who places a tube down the throat into the bronchial airways or makes an incision into the skin. Depending on the injury, a surgeon may also place a tube to remove excess air and suction out blood cells and fluid in the pleural space.

Recovery and Aftercare

It will usually take about 6 to 8 weeks to fully recover from a collapsed lung. However, the severity of the injury and the treatment method may make this period longer or shorter.
Some things you can do to aid recovery and prevent complications include:

  • Get plenty of sleep. You may feel weak and tired for a while, and that is okay.
    Take any medication your doctor prescribes exactly as directed. Ask about over-the-counter medication before taking any.
  • If you need to cough or take deep breaths, hold a pillow against your chest for added support and to decrease pain.
  • If you are prescribed antibiotics, take them as directed. Do not stop if you feel better and the full course has not yet been completed.
  • If you have a bandage over a tube or the area where a tube was, keep it clean and dry. Follow all instructions on care.
  • When you have a tube in place at home, follow all directions and do not adjust the tube in any way. This could break the seal or cause other problems. Ensure the tube is dry at all times.
  • Avoid movements that require your muscles, especially in the chest, to strain. This includes laughing hard, bearing down to have a bowel movement, and heavy lifting.
  • Do not fly in an airplane unless you are given the okay by your doctor.
  • Stay active with low-impact movement and incorporate rest.
  • Sleep in a position that elevates your torso in the first days.
  • Avoid unnecessary pressure being placed on the ribcage.
  • Wear loose-fitting clothing.
  • Avoid smoking and do not let others smoke around you.
  • Avoid any sudden changes in air pressure.
  • Avoid driving until you are fully recovered.
  • Closely monitor for signs of recurrence.
  • Follow your doctor’s instructions for breathing exercises.
  • Attend all follow-up appointments.

If you undergo surgery, recovery may be longer and more intensive. It is common to be recommended physical therapy after surgery to help you regain strength and lung capacity, especially if you are immobilized during immediate recovery. Any activity should be done under the supervision of your doctor and a licensed physical therapist to avoid further injury.

During recovery, if you begin to experience any symptoms again or notice a fever, new and worse pain, new and worsening trouble breathing, coughing up blood, or your chest tube coming out, you should seek immediate care. If you pass out for any amount of time or have severe trouble breathing, place a call to 911.

Potential Complications and Patient Outlook

While punctured lungs are serious, they are not fatal in most cases, and treatment is usually effective. The most common complication related to a punctured lung is the increased risk of suffering another one in the future. About 35% of people who have a punctured lung will have another one at some point.

Shock is also a common complication, especially when there is a serious injury or infection, severe inflammation, or fluid accumulation in the lung. Tension pneumothorax, which can cause cardiac arrest, is also a potential issue.

A healed pneumothorax usually does not have any long-term health implications if it is treated quickly, though trauma-induced collapses increase the risk of recurrence and may require more monitoring on an ongoing basis.

Can You Prevent a Punctured Lung?

There is no known way to prevent all pneumothorax, especially in patients with a family history of the condition. When trauma is the source, it may also be unavoidable. However, there are ways to reduce the chances of suffering from a punctured lung for those who may be at risk. Avoiding smoking is highly recommended, for example.

If you engage in activities that involve a drastic change in air pressure, like flying or diving, you may speak with your doctor about how to manage this.
For those with underlying lung conditions, continue to monitor appropriately with your physician.

Punctured Lungs and Car Accidents

While it is not the most common cause of punctured lungs, they are a potential outcome of motor vehicle collisions. This can occur in a variety of ways:

  • Seatbelts and airbags can cause a rib or multiple to break, and the jagged bone can puncture the lung.
  • Glass fragments from a windshield or window can puncture the lung.

Because of the traumatic nature of a car accident, many people experience shock and adrenaline rushes that hide symptoms of serious injuries. You may not notice chest pain or shortness of breath immediately following your crash and not be taken to a hospital for observation, even though your lung has been punctured. This is why it is critical to seek medical care as soon as possible after your accident.

A skilled doctor like those at AICA Lithia Springs will assess the entire body for injuries, even those there are no symptoms of yet. During a physical examination, if we notice a punctured lung, we will be able to use imaging technology to determine the next steps. This early intervention may be the difference between simple intervention and requiring surgery as the condition is allowed to worsen.

If you have recently been in an accident, contact AICA Lithia Springs today to schedule a consultation and gain peace of mind.


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