Traumatic pneumothorax refers to an accumulation of air in the pleural cavity due to trauma, leading to partial or complete collapse of the lung. Symptoms include pain in the chest due to the causal injury and sometimes wheezing. The diagnosis is made by X-ray examination of the chest. Treatment is usually with thoracostomy.
Spontaneous pneumothorax is discussed elsewhere (pneumothorax).
Traumatic pneumothorax refers to an accumulation of air in the pleural cavity due to trauma, leading to partial or complete collapse of the lung. Symptoms include pain in the chest due to the causal injury and sometimes wheezing. The diagnosis is made by X-ray examination of the chest. Treatment is usually with thoracostomy. Spontaneous pneumothorax is discussed elsewhere (pneumothorax). Pneumothorax may be caused by penetrierndes or blunt trauma; many patients also have a hemothorax (hemopneumothorax). In patients with penetrating trauma, passing through the mediastinum (z. B. wounds medial to the nipples or the shoulder blades) or with severe blunt trauma, pneumothorax can be caused by breakage of the tracheobronchial tree. Air from the pneumothorax may be in the soft tissue of the chest and / or neck (subcutaneous emphysema) or in the mediastinum (pneumomediastinum) penetrate. A simple one-sided pneumothorax, even if it is large, is well tolerated by most patients, unless they have a significant underlying lung disease. However, tension pneumothorax (pneumothorax (voltage)) lead to severe hypotension and open pneumothorax (pneumothorax (Open)) and interfere with breathing. Symptoms and discomfort patients often pleuritic chest pain, dyspnea, tachypnea and tachycardia. Breath sounds can be diminished and the affected hemithorax hyperresonant in percussion v. a. with a larger pneumothorax. However, these findings are not always available and can be difficult to detect during a noisy revival. A subcutaneous emphysema causes crackling or crack when it is sensed; Findings can be localized to a small area or take up a large part of the chest wall and / or expand to up to the neck; full participation suggests a fracture of the tracheobronchial tree. Air in the mediastinum can produce a characteristic crunch in synchronization with the heartbeat (Hamman’s sign or Hamman crunch), but this finding is not always available and will also occasionally causes injury of the esophagus. Diagnostic chest X-ray Diagnosis is usually made by chest x-ray. Sonography (performed at the bedside during initial resuscitation) and CT are more sensitive than X-ray thorax for small pneumothorax. The size of a pneumothorax is defined as the percentage of the hemithorax which is empty and can be estimated by X-ray findings (pneumothorax: Diagnostics). The numerical size is v. a. valuable for the quantification of progression and resolution, less to determine the prognosis. Clinical Calculator: degree of collapse in pneumothorax therapy Usually pleural drainage The treatment of most pneumothorax occurs with the insertion of a chest tube (eg 28 Fri) in the 5th or 6th intercostal space anterior to the axillary line. Pigtail catheter aspiration of pneumothorax video created by Hospital Procedures Consultants, www.hospitalprocedures.org. var model = {videoId: ‘4888683186001’, playerId ‘H1xmEWTatg_default’, imageUrl ‘http://f1.media.brightcove.com/8/3850378299001/3850378299001_4888769573001_vs-573344b9e4b02300f2f60f18-767904725001.jpg?pubId=3850378299001&videoId=4888683186001’ title: ‘pigtail catheter aspiration of pneumothorax’ description: ” credits ‘video created by Hospital Procedures Consultants, www.hospitalprocedures.org’ hideCredits: true hideTitle: false, hideDescription: true loadImageUrlWithAjax: true};. var panel = $ (MManual.utils.getCurrentScript ()) Closest ( ‘video element panel..’); ko.applyBindings (model, panel.get (0)); Patients with a small pneumothorax and without respiratory symptoms can be observed with serial chest radiographs simple until the lungs to expand again. Alternatively, a small Pigtailkatheterdrainage can be placed. However, it should be made a chest tube in patients who will receive a general anesthetic, positive pressure ventilation and / or respirator, as these interventions can convert a small, simple (simple) pneumothorax to a tension pneumothorax. If a large air leak exists for a thoracostomy is a violation of the tracheobronchial tree should be suspected and carried out bronchoscopy or immediate surgical consultation. Key points Physical findings can be subtle or normal, especially if the pneumothorax is small. Although CT and ultrasound are more sensitive, chest x-ray is usually sufficient for diagnosis. A chest tube is displayed when the pneumothorax caused respiratory symptoms, or if it is moderate or large, or if ventilator, positive pressure ventilation or general anesthesia is required.