Pneumothorax - air into the pleural cavity. There are spontaneous pneumothorax open, and the valve closed.
Most often, pneumothorax occurs when a breakthrough subpleurally
TB outbreak. Less commonly observed breakthrough purulent focus. Can
happen breakthrough in regional pleura bullous bubble in the so-called
bullous emphysema in a human before apparently healthy. in air
pleura and can penetrate from the outside due to penetrating trauma
thorax. Hole in the visceral pleura may close or
remain open for some time. There are cases when
hole opens during inhalation and closes during exhalation - valve
pneumothorax, wherein the pleural cavity develops in most
pressure. Breakthrough can happen in free of pleural adhesions
cavity in a limited space adnations.
The symptoms of pneumothorax
A break in the free pleural cavity suddenly arise
rezchayshie chest pain. Appears usually cyanosis, shortness of breath develops.
There is the phenomenon of shock: drop in blood pressure, heart palpitations,
cold sweat. The patient may die in the first hours.
Mostly sharp shock effects are mitigated, is shortness of breath,
cyanosis, orthopnea often (shortness of breath that occurs in the supine position). When the valve pneumothorax condition
progressively getting worse - growing shortness of breath, cyanosis; all tachycardia
Percussion reveals a more or less pronounced
tympanic (or lower "box") shade percussion
sound, but this is not always easily perceptible, especially in the presence of emphysema
other light. More important auscultation detects the absence of
or a sharp weakening of breathing (with clear percussion sound). A heart
sharply shifted to the opposite side (if there is no fixing it
Further typically begins accumulate fluid in the pleural cavity:
serous in tuberculosis, purulent (often putrid) in the breakout
abscess - pneumoempyema.
Pneumoempyema may appear in the breakout tuberculous cavity.
Further for these complications depends on the nature and
underlying disease. In general, spontaneous pneumothorax worsens
the basic process, but it is known that the tubercular process can
improve on the compression of the lung and lung abscess - "cure"
going to the pleural empyema. bullous bubble breakthrough occurs usually without
accumulation of fluid and favorably - air dissipates and the patient
He is recovering. Very hard proceeds valve pneumothorax.
X-ray examination revealed no
pulmonary drawing almost all over the affected half of the chest
cells; the outlines of a light preload, in the future may appear
horizontal level of liquid in the pleural cavity. A break in
space limited pleural splice clinical picture
less heavy and complaints can only be limited to short-term sharp
pain with shortness of breath or a breakthrough can occur even less noticeable.
Diagnosis of pneumothorax
Almost always placed correctly, if there is a doctor's idea
the possibility of spontaneous pneumothorax. You have to sometimes be distinguished from
myocardial infarction based on the absence of chest pain and a typical
irradiation, and based on auscultatory data. Helps
the diagnosis and identification of the character preceded this episode
disease. Diagnosis encysted small pneumothorax is often very
difficult and impossible without a thorough radiographic examination.
How is the treatment of pneumothorax
In the first period of treatment of pneumothorax - the fight against the phenomena of shock:
carefully prescribed drugs, but only when there is no
significant destruction of another lung), cardiovascular agents.
Sometimes you have to resort to vagosympathetic blockade. at
a significant shift of mediastinal organs shows a puncture of the pleura
pumping air when the valve pneumothorax required repeated
evacuating or leaving a broad spike with it fine
rubber tube, the other end of which is lowered into the vessel with
disinfectant solution. Resort to thoracoscopy with the coagulation
a valve portion. When the accumulation of fluid treatment is carried out by
principles of treatment of pleurisy.