Atelectasis vs Pneumothorax

What is atelactasis and pneumothorax?

Atelectasis is defined as the collapse of one or more areas of the lung whereas Pneumothorax is the presence of air in the pleural cavity. The pleura is a double layered protective covering which lines the outside of the lungs and the inside of the chest cavity. The space between the layers of the pleura is called as the pleural cavity and separates the lungs from the chest wall.

Difference in causes

Atelectasis is most commonly seen after surgeries of the chest and abdomen due to collapse of the air sacs (alveoli). Pneumothorax is an important cause of lung collapse. Atelectasis is caused due to obstruction of air passages by presence of foreign bodies, mucus plugs or tumours within the airways/in the wall of the airways. Atelectasis can also occur in premature babies due to absence of surfactant. Surfactant is the liquid which coats the inside of the lungs and helps the air sacs to stay open, absence of which will lead to a collapse of the lung. Atelectasis is also caused due to the presence of fluid in the pleural cavity in pleural effusion whereas

Pneumothorax is caused due to injury to the chest wall from a knife, sharp instrument or fractured rib. In tall, thin people, small air filled sacs in the lung called as blebs/blisters rupture and leak air into the pleural cavity causing spontaneous pneumothorax. It can also result from damage to the lungs seen in asthma, pneumonia, tuberculosis etc. Smoking and use of drugs are additional risk factors.

Difference in signs and symptoms

In atelectasis, patient complains of cough, chest pain, difficult breathing, increased heart rate and respiratory rate. In pneumothorax, there is dry cough, sudden onset of breathlessness and sharp, stabbing chest pain which increases with inhalation of air. In tension pneumothorax, there is entry of air in the pleural cavity but the air does not escape from the pleural cavity. This is a medical emergency. There is bluish discolouration of the skin, low blood pressure, increased heart rate, pulse rate and rapid breathing.

In both cases, X-ray and CT scan of the chest will help us to diagnose the condition. In atelectasis, there is shift of the windpipe (trachea) to the affected side whereas in pneumothorax, there is shift of the trachea to the opposite side.

Difference in treatments

In atelectasis, chest physiotherapy in the form of deep breathing exercises is advised. If there is a blockage then bronchoscopy can be done. In bronchoscopy, a thin flexible tube is inserted through the nose into the airway to clear the airway. If there is a tumour, then surgical removal of the growth with radiotherapy/chemotherapy is needed. Antibiotics are given to treat the infection and bronchodilators are used for sputum removal. In pneumothorax, we need to treat the underlying cause. A chest tube is placed in the chest cavity and suction of the air is done. In emergencies, we remove the air by inserting a needle in the chest cavity. In infections, antibiotics are given. Oxygen therapy may be given in certain cases.

Summary

Atelectasis is the collapse of one or more areas of the lung. The air sacs (alveoli) tend to collapse whereas pneumothorax is the presence of air in the pleural cavity. Atelectasis is caused due to obstruction of the airways by foreign body, mucus plugs or tumours. Atelectasis is seen in pneumothorax and pleural effusion whereas pneumothorax is caused due to trauma to the chest, sudden rupture of the air filled sacs in the lung. Pneumothorax is also seen in pneumonia, tuberculosis etc. Chest X-ray and CT scan will help us to diagnose the condition. In atelectasis, chest physiotherapy is useful. In pneumothorax, we need to insert a chest tube and treat the underlying cause.

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