Pneumothorax refers to an accumulation of air in the pleural cavity, leading to partial or complete collapse of the lung. A pneumothorax may occur spontaneously or resulting from an injury or a surgical procedure. Diagnosis is based on clinical criteria and the chest x-ray. Most pneumothorax require aspiration through a catheter or chest tube.

Pneumothorax refers to an accumulation of air in the pleural cavity, leading to partial or complete collapse of the lung. A pneumothorax may occur spontaneously or resulting from an injury or a surgical procedure. Diagnosis is based on clinical criteria and the chest x-ray. Most pneumothorax require aspiration through a catheter or chest tube. Etiology A primary spontaneous pneumothorax occurs in patients without underlying lung disease, klassischwerweise at large, thin young men in their teens and in the third decade of life. in that it is caused by spontaneous rupture of subpleural apical vesicles or bullae that arise from smoking or are inherited one takes. He usually occurs at rest on, sometimes during physical activities associated with stretching or stretching. The primary spontaneous pneumothorax occurs because of the uneven pressure balance in the lungs when diving and when flying at high altitude. A secondary spontaneous pneumothorax occurs with underlying lung disease in patients. Most commonly it is caused by rupture of a bubble or a bulla in patients with severe COPD (forced forced expiratory volume in 1 second [FEV1] <1 l), HIV-associated Pneumocystis jirovecii infection, cystic fibrosis or other underlying parenchymal lung disease (see Table causes of secondary spontaneous pneumothorax). A secondary spontaneous pneumothorax is more serious than a primary spontaneous pneumothorax because it usually occurs in patients whose underlying lung disease reduced their lung volume. A catamenial pneumothorax is a rare form of a secondary spontaneous pneumothorax, of within 48 h after the onset of menstruation in premenopausal women, and occasionally in postmenopausal women taking estrogens, occurs. Cause is an intrathoracic endometriosis, possibly peritoneal through immigration endometriosis by diaphragmatic gaps or embolic through the pelvic veins. Causes of secondary spontaneous pneumothorax type disease Frequent lung Asthma COPD Cystic Fibrosis Necrotizing pneumonia Pneumocystis jirovecii infection Tuberculosis Less common lung fibrosis Idiopathic pulmonary Langerhans cell histiocytosis lung sarcoidosis lymphangioleiomyomatosis Connective tissue disease ankylosing spondylitis Ehlers-Danlos syndrome Marfan's syndrome polymyositis and dermatomyositis RA Systemic sclerosis Other sarcoma Thoracic endometriosis tuberous sclerosis A traumatic pneumothorax is a common complication of penetrating or blunt chest injuries pneumothorax (traumatic). The iatrogenic pneumothorax is caused by medical procedures, incl. Transthoracic fine needle aspiration, thoracentesis, placement of a central venous catheter, mechanical ventilation and cardiopulmonary resuscitation. Pathophysiology The pressure in the pleural space is due to the restoring forces of the lungs and the chest wall to the inside to the outside is negative (lower than the atmospheric pressure). Pneumothorax when air enters from the outside or from the lung itself through mediastinal tissue surfaces or direct Pleuraperforation in the pleural space. The intrapleural pressure increases and the lung volume decreases. The tension pneumothorax (pneumothorax (voltage)) is a pneumothorax, which leads to a progressive increase in intrapleural pressure that is consistently positive, and the collapse of the lung, shift of the mediastinum and limitations of the venous return to the heart. Continuous air enters the pleural space, but can not escape. Without adequate treatment of impaired venous return to the systemic blood pressure and within minutes to respiratory and cardiac arrest (pulseless electrical activity) can result. Most often, the tension pneumothorax occurs in mechanically ventilated with positive pressures patients (with mechanical ventilation and esp. In resuscitation). Rarely it is a complication of a traumatic pneumothorax, when a wound is operating in the chest wall as a one-sided valve which attracts increasing volumes of air in the pleural cavity during inspiration. Symptoms and complaints Small pneumothorax are occasionally asymptomatic. The symptoms of pneumothorax are dyspnea and pleuritic chest pain. The dyspnea may occur suddenly or develop continuously, depending on the emergence of speed and size of the pneumothorax. The pain can be confused with pericarditis, pneumonia, pleurisy, pulmonary embolism, musculoskeletal injuries (for broadcast in the shoulder) or intra-abdominal process (for radiation into the abdomen). The pain can also stimulate cardiac ischemia, although the pain of cardiac ischemia typically are not pleuritisch. On physical examination, one finds traditionally a lack of tactile fremitus, hyperresonant percussion and quiet breathing sounds on the affected side. If the pneumothorax expanded, the affected side can be increased with a visible shift of the trachea to the opposite side. In tension pneumothorax hypotension may occur. Diagnostic chest X-ray Diagnosis is suspected in stable patients with dyspnea or pleuritic chest pain and confirmed with inspiratory chest x-ray standing. Radiolucent air and the absence of lung drawings next to a sunken rag or between the lung and parietal pleura are diagnostic of pneumothorax. Relocation of the trachea and mediastinum regarding large pneumothorax. Pneumothorax DU CANE MEDICAL IMAGING LTD / SCIENCE PHOTO LIBRARY var model = {thumbnailUrl: '/-/media/manual/professional/images/c0217945_pneumothorax_x-ray_science_photo_library_high_de.jpg?la=de&thn=0&mw=350' imageUrl: '/ - / media /manual/professional/images/c0217945_pneumothorax_x-ray_science_photo_library_high_de.jpg?la=de&thn=0 ', title:' pneumothorax 'description:' u003Ca id = "v38395449 " class = ""anchor "" u003e u003c / a u003e u003cdiv class = ""para "" u003e u003cp u003eEin pneumothorax is visible in the right lung

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