Briefly about the diagnosis of lung abscess. How to recognize the disease «Photo»? How to distinguish it from other lung diseases? How to treat abscess lung and whether the operation is needed? Everyone is gradually in the article.
Content
Abscess light — The disease in which the absence of timely competent treatment is inevitably leads to the emergence of complications and death of the patient. Its diagnosis usually does not cause difficulties, however, to distinguish the usual affectionate from the tuberculous cavity or the disintegrating tumor is very difficult.
Light abscess: radiograph
At the heart of the diagnostic search in the lung abscess — Picture of the disease, reinforced by radiographs. Abscess light by «Photo» made in the abscedization — This is a rounded intensive blackout. It must be said that the abscess of the right lung is more common and this is explained by the fact that the right bronchus is shorter and wider than the left, and therefore the aspiration mechanism of infection works here more.
In the second stage of the development of the disease, when the patient begins to distinguish the purulent sputter and the shell open, the abscess of the lung on «Photo» It looks different. This is the rounded shadow with the cavity, inside which is viewed horizontal fluid level. Interestingly, when changing the position of the patient, the level, «Digging» Harrot inside the lung abscess, also changes its direction. That is why it is in two projections to diagnose an abscess of light radiographs: in the patient's position lying on the side and standing. More accurate data on sizes, location, penette nature, the availability of pulmonary sequesters allows you to get computed tomography.
The pace of recovery of the patient directly depend on how well the sprode is leaving during the abscess, so radiography — This is not only a diagnostic tool, but also a way to control the effectiveness of treatment. Lifting the level of the liquid in the cavity of the gland testifies to the poor pus outflow and is a reason for the intensification of therapy.
Abscess and other lung diseases
Abscess left or right easily to distinguish from other diseases accompanied by similar radiological symptoms.
- Central lung cancer is often accompanied by the formation of foci of purulent-necrotic melting of tissues. Detect the tumor helps bronchoscopy, and biopsy will help verify the malignancy of the process.
- Disintegrating peripheral tumor or lung abscess? «Photo» cancec — This formation with thick walls and uneven internal circuits. Tranterakalny puncture biopsy helps clarify.
- The tuberculous cavity in light on the right is more common than the left, like the abscess of the right lung diagnose more often than the left. How to distinguish them, because the acute tuberculous process is clinically similar to the sharp abscess of the lung? Series «Photo» in dynamics, coupled with careful analysis of anamnestic data and a specific study on tuberculosis, implying the analysis of sputum and washing waters of bronchi on mycobacterium tuberculosis, will disappear all points above «and».
- Voaging cyst lung almost indistinguishable from lung abscess. On the radiograph, it looks like an education with clear contours and a thin wall, but at the same time the inflammation of the tissues of the lung around the cyst is quite slightly.
- Echinococcus cyst in the suppuration stage, too, practically, does not differ from the abscess, but sometimes together with the lung parasitic abscess of the lungs, the pieces of the chitin sheath of the worm.
- The inter-faith limited empy of the pleura on the right or on the left has x-ray features that distinguish it from the abscesses of the right or left lung. More accurate diagnosis requires tomography.
Light abscess: treatment
Treatment of lung abscess is carried out in a thoracic surgical department. The main task of therapy is to create an effective purge cavity drainage.
- Postural drainage — Passive emptying of purulent cavity, involving improved sputum selection under the influence of gravity. At the same time, the patient takes various poses with the slope of the body, on the side, on the stomach and, based on his experience, chooses a position in which the sputum is easier. Inhalation of bronchodilitics and antibiotics inhalations are used to improve pus outflow before the procedure.
- The catheterization of the abscess through the bronchus implies the holding of a thin catheter through the trachea and the bottom nasal stroke. Through this catheter, the cavity of the gland is irrigated by the solutions of antiseptics provoking the cough reflex, and the sputum is much more efficient. In the same way, bronchopholics facilitating drainage and enzymes that dilute sputum are introduced into the cavity of the abscess.
- In abscesses of light treatment, the bronchoscopic renovation and trachea.
- The transducer puncture of the lung abscess and its outdoor drainage is applied only if it was not possible to establish an effective emptying of the fusion of other methods.
Surgical treatment of lung abscesses is used in the absence of effect from conservative events.
- Pnemotomy implies thoracotomy by resection of fragments of one or two ribs, the subsequent autopsy and drainage of the um.
- Resection or removal of lung or part of it applies only in the case of an explicit threat of lung gangrenes.
Radical operations (lobectomy, pneumonectomy) — complex and fraught with various purulent complications, with lung abscesses are usually not used.
