Pneumothorax is a common clinical problem. Spontaneous pneumothorax is divided into PSP and SSP. This chapter will discuss the underlying causes of pneumothorax: underlying recognised chronic respiratory conditions, and familial and genetic conditions. Recurrence rates are high after a single episode, and vary by sex, age and comorbidity, but the case for recurrence prevention surgery has yet to be made. Prevention would appear to be best undertaken by VATS including chemical pleurodesis. Management remains predominantly that of admission and chest drain insertion. However, the results are eagerly awaited of trials of conservative and ambulatory management of pneumothorax, which could change the current treatment paradigm. Prediction models are required to predict those failing initial management and those at increased risk of recurrence. The underlying cause of PSP may be better understood by an improved understanding of the genetic predisposition and analysis of the inflammatory processes occurring in the lung parenchyma.

Cite as: Hallifax RJ, Walker S, Marciniak SJ. Pneumothorax: how to predict, prevent and cure. In: Maskell NA, Laursen CB, Lee YCG, et al., eds. Pleural Disease (ERS Monograph). Sheffield, European Respiratory Society, 2020; pp. 193–210 [https://doi.org/10.1183/2312508X.10023919].