Pneumothorax - this pathological accumulation of air or other gases into the pleural cavity leads to a violation of the ventilation and gas exchange function of the lungs during breathing.
Pneumothorax leads to compression of the lungs and the oxygen deficiency (hypoxic), metabolic disorders and respiratory failure.
Kinds
Pneumothorax There are two fundamentally different types depending on the origin and message with the external environment:
- closed when chest tightness maintained, and air or gases pass through the defect portion of the pleura, which communicates with the lungs. In this case the excess air or gas enters the pleural cavity of the respiratory tract.
- open when the gas or air is fed into the pleural cavity from the external environment through defects thorax - injuries, thus there depressurization respiratory system.
Development mechanisms release:
- outdoor pneumothorax when inspiratory air enters the pleural cavity, and leaves it on exhalation,
- closed (tight) acts on the valve mechanism. On the inhale the air enters the pleural cavity, and the compressed air to escape without giving back, resulting in the pleural cavity in the tissue exhale slowly but surely growing pressure.
Also produce:
- spontaneous pneumothorax that occurs without any preceding illness, or illness that flowed hidden
- secondary pneumothorax which arises as a complication of pulmonary or extrapulmonary pathology
- artificial pneumothorax, which is created when doctors need specific manipulations.
Causes
The main reasons for pneumothorax may include several groups:
- injuries, mechanical injuries of the chest and lungs closed nature with broken ribs and lung injury by them,
- penetrating wounds of the chest (gunshot, stab)
- complication of diagnostic or therapeutic measures (in the formulation of the catheter, puncture, nerve blocks)
- the imposition of an artificial pneumothorax in the diagnosis or treatment.
Another group of reasons - it defeats and diseases of the chest cavity - breaks bulls and cysts in emphysema lung abscesses breakthroughs, esophageal rupture, tuberculous process tumoral processes to melt pleura.
Pneumothorax usually occurs on one side, but may be a two-way, normally major injury or severe damage to the lungs and pleura.
signs of pneumothorax
Clinic manifestations pneumothorax will depend on what the cause of it caused and how much constricted lung or both of them.
Symptoms of open pneumothorax
With an open pneumothorax patients usually lie on the affected side of the chest, his hands clutching the wound. In this highly audible noisy air sucked into the chest cavity, the oozing at the wound site foamed blood, when viewed from the chest is asymmetrical, as lung damage is less involved in breathing.
Symptoms of spontaneous pneumothorax
Spontaneous pneumothorax occurs acutely, usually preceded by episodes of severe coughing or severe physical effort, sometimes even quite deep breath.
Typical onset of pneumothorax gives strong stabbing pain in the affected lung recoil in the breast or neck and arm.
When coughing or deep breathing pain stronger movements provoke increased pain, which may cause a fear of death and panic.
When pain syndrome also occurs dyspnea, depending on the degree of compression of the lung may occur signs respiratory distress, cyanosis of the face or sudden paleness, dry cough that patients suppressed due pain.
With increasing pain symptoms subside, shortness of breath becomes weaker and pain only occurs during deep breathing or moving the patient. May occur subcutaneous heave (emphysema) in the area of the wound or in the neck and face, that provides a crunch feeling when pressing on the abdominal area.
When listening to the lungs it will be greatly weakened breathing or not breathing easy. Begin to show signs of pneumothorax during lung volume reduction of 30-40%, with the development process pleura becomes inflamed and after a few hours edema and fibrin deposits on the pleura, resulting in adhesions between the lung and pleura, which will then interfere with normal expand to a light at treatment.
Diagnostics
Diagnosis of suspected pneumothorax scurried to inspection and listening to the lungs with the identification of areas of lack of breath from the bottom.
In addition, given the suspicions are typical symptoms from the patient - a forced body position, pressure reduction, indications of chest trauma, respiratory disorders.
The final verdict makes X-rays, which shows preloaded lung zone and air in the pleural cavity, as seen in the displacement bodies away from the lesion.
Help establish a diagnosis of pleural puncture to obtain gas or air, the pressure in the cavity will be zero.
pneumothorax treatment
Pneumothorax - a condition requiring emergency care, which will in the hospital. Treat pneumothorax, surgeons and pulmonologists. Outdoor pneumothorax requires airtight dressing valve - emergency puncture with venting and a further operation to remove the suction valve.
In further hospital treatment will depend on the reasons pneumothorax - the removal of air, restoration of normal pressure in the pleural and suturing wounds, removal of fragments edges surgery light, etc.
In order to prevent the development of pneumothorax repeatedly carried out pleurodesis procedure - creating artificial pleural adhesions in a fully straightened light.
The prognosis after pneumothorax
Treatment and rehabilitation after pneumothorax last from 1-2 weeks to a few months, it all depends on the cause.
The prognosis of pneumothorax depends on the extent of damage and the rate of respiratory failure. In the case of wounds and injuries can be disadvantageous.
