A pathological condition in which air or other gas mixtures accumulate in the pleural cavity (slit-like space between the parietal and visceral pleura that surround each lung) is called pneumothorax. Symptoms, causes and treatment of this condition will be discussed in the article.
General information
Negative pressure is characteristic of the pleural cavity in a normal state, this provides an adequate breathing mechanism. If the pleural sheets are damaged (for example, as a result of a rupture of a section of the lung or bronchus), and air enters the pleural cavity, the pressure equalizes with atmospheric pressure or exceeds it. The air that has entered the pleural cavity leads to compression of the lung, provokes its collapse and exclusion from the act of breathing. With a large volume of air, the intact lung is also subjected to compression, in addition, there is a displacement of the mediastinal organs (large vessels, heart). All this significantly disrupts the mechanism of blood circulation and respiration.
Pneumothorax: symptoms of pathology
This disease is manifested by the following symptoms:
- Suddenly occurring pain in the chest - acute, aggravated during inspiration. Pain may radiate to the shoulder of the affected side.
- Suddenly developing shortness of breath - shortness of breath, rapid shallow breathing.
- Dry cough.
- Increased heart rate.
- The appearance of cold sweat on the skin.
- General weakness.
- Feeling fear.
-
Cyanosis of the skin (if circulatory and respiratory disorders are pronounced).
spontaneous pneumothorax symptoms
Disease forms
-
Open pneumothorax. Symptoms in this condition are as follows: the air that has penetrated into the pleural cavity through a damaged large bronchus or chest wound communicates with the environment, during inhalation, air enters the pleural cavity and exits during exhalation. The pressure in the pleural cavity is compared with atmospheric pressure, which provokes the collapse of the lung and turning it off from the breathing process.
- Pneumothorax closed develops when air enters the pleural cavity due to a defect in the pleura. There is no communication between the pleural cavity and the environment, and the trapped air does not increase in volume. Closed pneumothorax has the mildest course from a clinical point of view. Air in a small amount can resolve on its own. If a closed pneumothorax occurs, the symptoms in this case are as follows: pain on the damaged side of the chest,pale skin, shortness of breath.
-
Tension (valvular) pneumothorax. This type of pathology is the most severe. A symptom of valvular pneumothorax is the formation of a medium-sized valvular structure with a large wound and damage to the bronchus, which allows air to enter the pleural cavity during inhalation and prevents it from escaping into the external environment. The volume of air in the pleural cavity increases. This provokes displacement and compression of the mediastinal organs with serious circulatory and respiratory disorders.
pneumothorax closed
Pneumothorax: causes of disease
Depending on the causes, several types of illness are distinguished.
Spontaneous pneumothorax
Symptoms of pathology are caused by a rupture of a section of the lung or bronchus, which is not associated with mechanical damage to the chest or lung. Spontaneous pneumothorax can be:
1. Primary (idiopathic), arising for no apparent reason. Young men of high stature 20-40 years old are more susceptible to this condition. Most often, pathology develops due to:
- genetically determined deficiency of the enzyme alpha-1-antitrypsin, which provokes pathological changes in the lungs;
- congenital weakness of the pleura, which can easily burst with laughter, severe coughing, intense physical exertion, deep breathing;
-
pressure drop due to deep diving, diving, flying in an airplane.
pneumothorax treatment
2. Secondary (symptomatic), when spontaneous pneumothorax develops against the background of an existing lung pathology. Symptoms of the disease occur due to:
- respiratory diseases, for example, it can be chronic obstructive pulmonary disease (a chronic inflammatory disease of the respiratory system that develops under the influence of various environmental factors, the main of which is smoking, which provokes the development of chronic respiratory failure), cystic fibrosis (hereditary disease, which is characterized by a violation of the activity of the glands of external secretion), severe exacerbation of bronchial asthma;
- infectious diseases of the lungs, such as tuberculosis (an infectious disease caused by mycobacteria), lung abscess (a limited focus of inflammation of the lung tissue, which is characterized by melting of the lung tissue and the formation of a cavity filled with purulent contents), inflammation of the lungs (pneumonia) on background of HIV infection;
- lung diseases characterized by connective tissue damage: fibrosing alveolitis, lymphangioleiomyomatosis, sarcoidosis, histiocytosis X;
- systemic connective tissue pathologies with lung involvement: systemic scleroderma, rheumatoid arthritis, dermatomyositis;
- tumors (lung cancer).
Traumatic pneumothorax
The causes of this phenomenon are chest injuries:
- blunt trauma;
- penetrating wound.
Iatrogenic pneumothorax
This pathology is the result of certain medical manipulations:
- pleural or lung biopsies;
- puncture;
- subclavian catheter placement;
- artificial lung ventilation.
Diagnosis
In order to make a diagnosis of pneumothorax, the symptoms of the pathology must be carefully studied by a specialist during the medical examination. Diagnosis includes the following activities:
- Examination of the patient: auscultation (listening) of the lungs, examination of the chest.
- Chest x-ray, which can detect air in the pleural region. The procedure is the main method for diagnosing pneumothorax.
- Blood gas analysis.
- Computed tomography, which allows you to identify the causes of the development of secondary spontaneous pneumothorax. This diagnostic method is used if radiography is not informative enough.
- Electrocardiography, with which it is possible to detect violations of the heart in valvular (tension) pneumothorax.
-
Consultation with pulmonologist and thoracic surgeon.
closed pneumothorax symptoms
Emergency
You should know how to provide first aid for such a pathological condition as pneumothorax. Its symptoms should besignal for emergency medical action. The patient must first of all be provided with free access to oxygen, calm him down and immediately call a doctor.
Open pneumothorax involves the imposition of an occlusive bandage that will seal the damaged area of the chest wall. A bandage that will not let air through can be made from polyethylene or cellophane and a thick cotton-gauze layer.
Valvular pneumothorax requires an immediate pleural puncture to help expand the lung, eliminate free gas, and prevent mediastinal displacement.
Measures to combat pathology
If a pneumothorax is diagnosed, treatment involves the following activities:
- Pleural puncture, in which air is sucked out of the pleural cavity.
- Surgical closure of ruptured bronchi, lung, chest wall wounds.
- Drainage of the pleural cavity with the establishment of a drainage tube through which air will be removed from the pleural cavity.
- If pain is severe with a condition such as pneumothorax, treatment may include the use of painkillers.
- Oxygen therapy (continuous supply of oxygen through special tube systems).
-
Pleurodesis - a procedure for fusion of the pleura with the help of surgery or the introduction of special medications into the pleural cavity (if pneumothoraxes recuroften).
pneumothorax causes
Complications and consequences
Pneumothorax is a serious condition that can cause:
- Intrapleural bleeding.
- Pleuritis - inflammation of the pleura, which is characterized by the formation of adhesions that provoke violations of the expansion of the lung.
- Subcutaneous emphysema - a phenomenon in which air escapes into the subcutaneous fat. The condition is determined by areas of swelling, swelling of the subcutaneous tissue: when you press them, a characteristic sound occurs, similar to the crunch of dry snow.
- Air entering the tissue of the mediastinum. In this case, compression of large vessels and the heart is observed.
- In especially severe cases (with a large amount of damage, a significant penetrating wound of the chest), a lethal outcome is not excluded.
Prevention
To prevent pneumothorax, you should follow certain rules:
- Treat lung diseases promptly.
- Stop smoking.
- Avoid chest injury.
-
If pneumothoraxes occur frequently, a pleurodesis (fusion of the pleura) is recommended.
open pneumothorax symptoms
Conclusion
In this article we have discussed such a disease as pneumothorax. Symptoms, causes and principles of treatment of pathology were considered by us. For any pneumothoraximmediate hospitalization of the patient for surgical treatment is necessary. With adequate modern therapy, the prognosis of spontaneous pneumothorax is usually favorable. The nature of concomitant chest injuries affects the success of the treatment of traumatic pneumothorax. Take care of yourself and stay he althy!
