A pneumothorax (pleura) occurs when air or other gases enter the pleural cavity. This disease is included in the so-called emergencies, usually requiring urgent, immediate surgical intervention. What are the causes and symptoms of pneumothorax? How is it treated?

Pneumothoraxis the presence of air in the pleural cavity. Normally, there is a vacuum between the two pleural plaques, which allows the alveoli to be filled with air. When gases enter the pleural cavity, they begin to compress the alveoli, damaginglung . As a result, it stops working.

Pneumothorax - causes

Pneumothoraxmay arise as a result of a chest injury, with a rib fracture, or it may also be the result of puncture of the chest with a sharp instrument from the outside.

There is a pneumothorax:

  • closed
  • open
  • valvular
  • intrinsic
  • post-traumatic.

Pneumothorax - types

  • Closed emphysema- is a one-time intrusion of a certain amount of air into the pleural cavity. Most often it occurs as a result of rupture of the emphysema bladder or perforation of the pulmonary parenchyma or the chest wall by a foreign body or a rib. Closed emphysema can be small or large. The former usually does not require treatment. The second (dropping more than 25% of the lung on one side) requires decompression, that is, suction of air. The procedure involves puncturing the pleural cavity with a needle or a drain, most often in the second intercostal space, in the mid-clavicular line, and connecting it to the suction system. However, there is a risk that this type of pneumothorax will recur as a result of the rupture of successive or the same emphysema bladder or as a result of a bone fragment piercing the pulmonary parenchyma. Then urgent surgical intervention is necessary.
  • Open pneumothoraxoccurs when the chest wall is pierced and a yawning wound is formed that connects to the pleural cavity. As a result of the increase in pressure in the pleural cavity, the lung collapses (normal pressure in the pleural cavity is lower than the atmospheric pressure). This type of pneumothorax is a direct threat to life as one lung failswork. In addition, there is then the so-called paradoxical respiration - this is a phenomenon consisting in the swinging movement of gases from one lung to another, which in turn increases the limitation of respiratory capacity.
  • Valvular pneumothoraxotherwise it is called a tension pneumothorax. In this case, the air flows from the pulmonary parenchyma into the pleural cavity due to the rupture of a small piece of lung tissue during inhalation. With each subsequent inhalation, more air flows into this closed space, increasing the pressure in the cavity. Advanced valve pneumothorax presses on a he althy lung, impairing its function.
  • Spontaneous pneumothorax- its causes are often unknown. One reason may be a spontaneous rupture of the emphysema, for example in people who have smoked for many years. In young, non-smoking people it may be alpha-1-antitrypsin deficiency. And the second cause of spontaneous pneumothorax in young people may be the so-called Marfan's syndrome (genetic disease of connective tissue).
  • Post-traumatic pneumothorax- is the result of air entering the pleural cavity as a result of an injury.

Pneumothorax - symptoms

The symptoms of pneumothorax are quite characteristic:

  • sudden stabbing pain in the chest
  • pallor
  • cyanosis
  • shortness and rapid breathing
  • anxiety
  • tachycardia
  • voice tremor
  • dry cough
  • weakness
  • fainting.

There is an intense or drum-like tapping noise on the exam.

Pneumothorax - treatment

Major pneumothorax is treated surgically by inserting a drain into the pleural cavity and sucking air to create a constant negative pressure. Small pneumothoraxes can be treated by suctioning the air with a syringe and lying down, and often only the treatment itself helps.

In the case of secondary pneumothorax, thoracotomy or videotoracoscopy (VATS), combined with pleurodesis, may be indicated.

People who have had a pneumothorax should avoid sudden changes in pressure (high altitude flying, diving, bungee jumping or parachuting). In such cases, jogging and long walks are recommended.

Complication of pneumothorax may be pleural adhesions and fluid formation.

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Category:

Respiratory system