Aetiology of spontaneous pneumothorax

Causes of spontaneous pneumothorax include:

• in primary pneumothorax
  • typically occur in tall, thin males
  • underlying small subpleural bleb or bulla
  • tobacco smoking
    • a retrospective study carried out in Stockholm have revealed that relative risk of a first pneumothorax is increased by ninefold in women who smoke and by 22-fold in men who smoke
    • in addition there is an association between the number of cigarettes smoked a day and risk of pneumothorax.
• in secondary pneumothorax
  • obstructive lung disease – COPD (commonest cause), aasthma
  • suppurative lung disease – bronchiectasis, cystic fibrosis
  • lung malignancy
  • infections – pneumonia, tuberculosis
  • interstitial lung disease - pulmonary fibrosis, extrinsic allergic alveolitis
  • thoracic endometriosis (1,2)

Reference:

• (1) Bintcliffe O, Maskell N. Spontaneous pneumothorax. BMJ. 2014;348:g2928
• (2) Currie GP et al. Pneumothorax: an update. Postgrad Med J. 2007; 83(981): 461–465