What to Know About Pneumothorax in Children

Medically Reviewed by Dan Brennan, MD on August 06, 2022

Pneumothorax is the medical term for a collapsed lung that happens when air leaks outside the lung and creates pressure. It’s a rare condition, but it needs immediate medical attention. While this condition can affect a person of any age, here is a quick look at the symptoms, causes, diagnosis, and treatments for pneumothorax in children.

What Is a Pneumothorax?

A pneumothorax is an air leak from the lungs into the pleural space, which is the space between the lungs and the chest. The air that leaks into the pleural space presses on the lung and can cause it to collapse. 

A pneumothorax may start quickly or slowly. It often occurs in children within 24 to 36 hours of their birth. The seriousness of the pneumothorax depends on its location, speed, and size.  

Children may experience different types of pneumothorax, including: 

Primary spontaneous pneumothorax. In a primary spontaneous pneumothorax, a weak spot on the surface of the lungs ruptures and causes an air leak. 

Secondary spontaneous pneumothorax. A secondary spontaneous pneumothorax is more common in children with lung conditions, such as cystic fibrosis and asthma.

Traumatic pneumothorax. A traumatic pneumothorax happens when an injury damages the lungs and causes a leak. Injuries such as a fall, a car accident, a hit, or breaking a rib could cause this type of pneumothorax.

Iatrogenic pneumothorax. Some medical procedures, such as getting a large IV in the chest or neck or mechanical ventilation can cause an iatrogenic pneumothorax. Babies who are born with a lung disease may be put on a mechanical ventilator to aid their breathing and have the highest risk of getting a pneumothorax. 

Other Causes of Pneumothorax in Children

Some other health conditions can also cause pneumothorax. Meconium aspiration happens when a newborn breathes in a mixture of meconium, its first stool, and amniotic fluid. This can cause a pneumothorax. 

Children with certain health conditions are at increased risk of pneumothorax. These include children whose lung tissues are weak and those with lung diseases like respiratory distress syndrome.

Symptoms of a Pneumothorax

Symptoms of a pneumothorax differ from one child to another, but some of the most common are:

  • Flaring of the nostrils
  • Sinking in of the skin around the ribs as the child breathes
  • Breathing rapidly
  • Restlessness
  • Grunting
  • Pale or bluish skin (caused by a lack of oxygen)
  • Sharp chest pain that may extend to the shoulders and back

If your child has any of these symptoms, it’s important to check with a healthcare provider as soon as possible. Even if your child does not have a pneumothorax, many of these symptoms could also indicate other health conditions. It is also possible for your child to have a pneumothorax without showing any visible symptoms.

How Is a Pneumothorax Diagnosed?

Your healthcare provider may check your child’s heartbeat and lung functions using a stethoscope and measure their oxygen levels. The healthcare provider may also look at your child’s medical history for relevant information and recommend testing that can show if your child has a pneumothorax. Several tests are used for diagnosis, including: 

Transillumination. A healthcare provider often does this test in emergency situations. The provider places a fiber-optic probe on your child’s chest wall. The side of the chest with the leak will appear brighter than the other side.

Chest X-rays. Chest X-rays give the healthcare provider a clear picture of your child’s tissues, bones, and internal organs and show the presence of air in places where it should not be. Chest X-rays also show if the lung has collapsed and if the chest organs are out of their normal positions.

Computed tomography (CT) scan. This test uses a combination of X-rays and computer scans to get clear images of the lungs.

How Is a Pneumothorax Treated?

Pneumothorax treatment depends on many factors, such as your child's symptoms, age, and overall health. 

In some cases, the air leak does not lead to any discomfort and does not cause any major symptoms. The leak in such cases may improve over time without any treatment. The area around the leak heals, preventing any further leaks, and the body absorbs the air that has leaked from the lungs.

In more serious cases, your child may be admitted to a hospital and stay there overnight for observation. If the leak needs treatment, the healthcare provider may recommend any of the following.

Aspiration. A healthcare provider inserts a needle into the pleural space between the ribs to remove the air that is trapped and bring breathing back to normal.

Catheter placement. A healthcare provider inserts a thin tube (catheter) into the pleural space. They connect the other end of the tube to a suction device that removes the trapped air and allows the lungs to expand to their normal size. The healthcare provider may leave the tube in until the leak heals completely.

Surgery. A healthcare provider will recommend surgery when none of the above methods work or if your child has had a previous pneumothorax. A surgeon removes any weak spots in the lungs (blebs) or closes them off to prevent air leaks from the lungs. Surgical techniques can also thicken the surface of the lungs and make future leaks less likely.

Pneumothorax Precautions

Although pneumothorax treatments are effective, your child may be at risk of getting a pneumothorax again in the future. A pneumothorax is a serious condition that can even lead to cardiac arrest or death, and it is important to know how to take care to prevent it from happening again. Your healthcare provider may recommend that your child avoid scuba diving, air travel, and other activities that could put pressure on their lungs and cause another pneumothorax.

If your child does show any symptoms of a pneumothorax, be sure to contact your healthcare provider. If the symptoms are serious, such as difficulty breathing, your child may need immediate medical attention.

Show Sources


Cedars Sinai: “Pneumothorax in Children.”

Cleveland Clinic: “Collapsed Lung (Pneumothorax).”

Saint Luke’s: “When Your Child Has Pneumothorax.”

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