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In some lung diseases, especially emphysema, it is possible for abnormal lung areas such as bullae (large air-filled sacs) to have the same appearance as a pneumothorax on chest X-ray, and it may not be safe to apply any treatment before the distinction is made and before the exact location and size of the pneumothorax is determined. [15]
Complications are not common but include infection, lung abscess, and bronchopleural fistula (a fistula between the pleural space and the bronchial tree). [4] A bronchopleural fistula results when there is a communication between the laceration, a bronchiole, and the pleura; it can cause air to leak into the pleural space despite the placement of a chest tube. [4]
A coin test (or a bell metal resonance) is a medical diagnostic test used to test for a punctured lung. A punctured lung can cause air or fluid to leak into the pleural cavity, leading to, for example, pneumothorax or hydrothorax. In a coin test, a coin held against the chest is tapped by another coin on the side where the puncture is suspected.
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A pulmonary contusion, also known as lung contusion, is a bruise of the lung, caused by chest trauma. As a result of damage to capillaries, blood and other fluids accumulate in the lung tissue. The excess fluid interferes with gas exchange, potentially leading to inadequate oxygen levels .
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Chest trauma, a major cause of subcutaneous emphysema, can cause air to enter the skin of the chest wall from the neck or lung. [9] When the pleural membranes are punctured, as occurs in penetrating trauma of the chest, air may travel from the lung to the muscles and subcutaneous tissue of the chest wall. [9]