The cause of a closed or primary spontaneous penumothorax is the rupture of a bleb (vesicle) on the surface of the visceral pleura. Secondary spontaneous pneumothorax can result from chronic obstructive pulmonary disease (COPD), which is related to hyperinflation or air trapping, or from the effects of cancer, which can result in the weakening of lung tissue or erosion into the pleural space by the tumor. Blunt chest trauma and penetrating chest trauma are the primary

744 Pneumothorax causes of traumatic and tension pneumothorax. Other possible causes include therapeutic procedures such as thoracotomy, thoracentesis, and insertion of a central line.

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