Lung abscess - a disease in whichlack of timely treatment literacy inevitably leads to complications and death of the patient. Diagnosing it is usually not difficult, however, to distinguish normal from tubercular abscess cavity or decaying tumor very difficult.
The basis of diagnostic search in abscesslight - the picture of the disease, supported by X-ray diffraction data. Lung abscess on "photos" made in the stage of abscess - a rounded intense shade. I must say that the right lung abscess is more common and it is because the right bronchus is shorter and wider than the left, which means that the aspiration mechanism of infection is often triggered.
In the second stage of the disease whenthe patient begins to stand and purulent sputum abscess is opened, lung abscess in the "photo" already looks different. This rounded shadow with a cavity inside which the horizontal level of liquid visible. Interestingly, when changing the position of the patient, the level of "Incised" sputum in lung abscess, also changes its direction. That is why for the diagnosis of lung abscess radiograph made in two projections: in the position of the patient lying on his side and standing. More accurate data on the size, location, nature of the ulcer, the presence of pulmonary sequestration provides a computed tomography.
The pace of recovery of the patient is directly dependent onhow well sputum departs in abscess, so the X-rays - is not only a diagnostic tool, but also a way to monitor the effectiveness of treatment. The rise of the liquid level in the cavity of the abscess shows poor outflow of pus, and is the reason for the intensification of therapy.
Abscess of the left or of the right lung to be distinguished from other diseases associated with a similar radiological symptoms.
- Central lung cancer is often accompanied byformation of pockets of purulent necrotic tissue meltdown. Discover the tumor helps bronchoscopy and biopsy will help to verify the malignancy process.
- Disintegrating peripheral tumor or abscesseasy? "Photo" cancer - is the formation of a thick walls and uneven internal circuits. Clarify diagnosis helps transtorakalnyya needle biopsy.
- Tuberculosis in the lung cavity from the right foundmore often than on the left as the right lung abscess diagnosed more often than the left. How to distinguish them, because acute tubercular process is clinically similar to acute lung abscess? A series of "photo" in the dynamics, coupled with a thorough analysis of anamnestic data and specific research on tuberculosis, implying the analysis of sputum and bronchial tubes wash water to Mycobacterium tuberculosis, to dot the "i".
- Festering cyst lung virtually indistinguishableof lung abscess. On radiographs, it looks as education with clear contours and thin wall, but the inflammation of lung tissue around the cyst only slightly.
- Hydatid cyst in the stage of suppuration, too, practically does not differ from the abscess, but sometimes with sputum from lung abscess depart parasitic pieces of chitin shell worm.
- Interlobar empyema limited right or left is radiologic features that distinguish it from the abscesses of the right or left lung. More accurate diagnosis requires a scan.
Treatment of lung abscess is held in thoracic surgical department. The primary goal of therapy is to provide effective drainage of purulent cavities.
- Postural drainage - passive emptyingpurulent cavity, suggesting improvement in sputum discharge by gravity. At the same time the patient takes various postures with an inclination of the body, on its side, on the abdomen and on the basis of their experience, choose the position in which phlegm departs easily. To improve the drainage of pus before the procedure used inhaled bronchodilators and antibiotics.
- Catheterization abscess bronchus through meansholding a thin catheter through the trachea and lower nasal passage. Through this catheter abscess cavity irrigated with antiseptic solution, triggers the cough reflex and mucus moves much more efficiently. In the same way in the abscess cavity bronchodilators are administered to facilitate drainage and enzymes, thinning sputum.
- When lung abscess treatment necessarily involves bronchoscopic reorganization of the bronchi and trachea.
- Transthoracic puncture lung abscess and external drainage is used only in the event that it was not possible to establish effective methods of emptying an abscess others.
Surgical treatment of lung abscess is used in the absence of effect of conservative measures.
- Pneumonopathy involves resection thoracotomy through the fragments of one or two ribs, the subsequent opening and drainage of abscess.
- Resection or removal of a lung or part of it is used only in case of imminent threat of gangrene of the lung.
Radical surgery (lobectomy, pneumonectomy) - are complex and fraught with various purulent complications, lung abscesses are not commonly used.