Lung hypoplasia is a congenital phenomenon, expressed in the underdevelopment of all structures of the respiratory system - the parenchyma, blood vessels and bronchi. Pathology is often accompanied by various complications: from inflammation of the parenchyma to cystic formations in the bronchi. This condition of the lungs significantly delays the development of the child, and in severe cases leads to death.
Lung hypoplasia is of two types - simple and cystic. In the first case, the pathology proceeds imperceptibly and is detected only in the case of an infection, that is, in the process of its diagnosis and treatment. Cystic hypoplasia of the lung presents with characteristic signs almost immediately after birth.
Causes of hypoplasia
Lung hypoplasia in children develops at the stage of embryonic development. It is known that the lungs begin to form already in the second month of pregnancy, and if at this moment there is a violation of the differentiation of the componentsof this organ, then as a result they are not fully formed.
There are several reasons for this pathology:
- The lung may not fully develop as a result of the large amount of fluid in it.
- The lung does not grow if it is pressed by a herniated diaphragm.
- Hypoplasia of the left lung in a child (as well as the right one) may be the result of a curvature of his spine. In which direction he bent, then the lung and cannot grow properly, clamped by it.
- Hypoplasia of the lungs occurs when oligohydramnios is caused by abnormal and irregular urine output. That is, the pathology is a consequence of a violation of the urinary system.
- Congenital lung hypoplasia can be inherited at the gene level.
- Underdeveloped blood vessels increase the likelihood of lung pathology.
Classification of pathology
Lung hypoplasia is divided into several types. In this case, the classification occurs according to the degree of damage to the respiratory organ and the reasons for its occurrence.
Code for lung hypoplasia according to ICD-10 (International Classification of Diseases 10th revision) - Q33.0.
To understand the diversity of pathology, it is easier to display it as a list:
- Q33.1 – pathology affecting the accessory lobe of the lung.
- Q33.2 - a pathology accompanied by lung sequestration.
- Q33.3 – lung agenesis
- Q33.4 Congenital bronchiectasis.
- Q33.5 – ectopic lung tissues
- Q33.6 –dysplasia of the lungs.
- Q33.9 - atypical hypoplasia, i.e. without known cause
You should also know that lung hypoplasia in newborns can affect one or two lungs at once. In other words, be one-sided or two-sided.
There is also a cystic form of pathology. It is characterized by the presence of cysts in the bronchi and lungs of an infant. They are single or multiple, in which case polycystic hypoplasia occurs.
Symptoms of hypoplasia
Manifestations of lung hypoplasia (ICD-10 code - Q33.0) depend on the form of the disease, its severity. For example, underdevelopment of 1 or 2 segments of the lung proceeds practically without any manifestations. But if a child has a lesion of 3 or more segments, then the symptoms, respectively, become noticeable. With the polycystic form, the symptoms are even more pronounced.
A child with underdeveloped lungs often has a deformed chest or a curved spine. It arches to where the light is small and underdeveloped.
Pathology is often accompanied by pain in the chest and the appearance of blood when coughing.
Underdeveloped lungs supply little oxygen to the body. Over time, a person develops shortness of breath, and a chronic lack of oxygen leads to acrocyanosis, the upper phalanges on the fingers thicken.
When an infection enters an underdeveloped lung, pneumonia develops, flowing into a chronic form.
A person with this pathology has been tormented by a hoarse cough with sputum production almost all his life. He feels all his lifebad.
Rarely, when in an organism with underdeveloped lungs, all other organs grow he althy and normal. Often, hypoplasia is accompanied by such congenital defects as heart disease, inguinal hernia, splitting of the sternum. The skeleton of such a person also suffers, he often has a curvature of the hands, feet and even facial bones.
Hypoplasia should not be left untreated, because it can affect the condition of the human heart and cause severe bleeding from the lung.
Symptoms of cystic hypoplasia
The cystic form of the disease most often begins to manifest itself at the age of 10 years and older.
A child with a cystic form of pathology has a pronounced keeled chest, does not tolerate physical activity, lags behind in development, both physical and intellectual.
Clinical manifestations occur only after joining the infection. In this case, the patient has a cough with sputum production. Shortness of breath appears and arrhythmia is fixed.
Mild form of the disease is perceived as a cough with a small amount of sputum. This condition usually goes away after a few days. Despite the often repeated periods of coughing, the correct diagnosis is not carried out, and the patient's condition is perceived as a mild form of pneumonia. The fact that he has congenital lung hypoplasia (according to ICD 10 code - Q33.0) a person learns only after a deep and comprehensive diagnosis.
Diagnosis of hypoplasia
First of all, a pathology can be diagnosed with an external examination of the patient. After all, underdeveloped lungs lead to a curvature of the chest. It may be keeled, like a dog, may be skewed towards one underdeveloped lung. Separate ribs of the chest bulge or fail relative to the rest. But all this can be seen only with a pronounced pathology. In a mild form of hypoplasia, an X-ray can help to see the curvature of the skeleton.
All shifts, shadows and deformations are perfectly visible on x-rays. Moreover, this study may reflect underdeveloped vessels in the affected lung.
Bronchoscopy is used to determine the presence of inflammation in the lungs and bronchi. This method allows you to assess the degree of inflammation of the mucous membrane of the bronchi and segments of the lungs.
And such a research technique as bronchography helps to assess the degree of development of bronchial branches, their number and structure.
Perfusion lung scintigraphy is used to determine the exact border of the underdeveloped lung parenchyma.
Treatment of hypoplasia
Conservative treatment is used only in a mild form of pathology, or at its very beginning, until it has led to physical changes in the body. The course of such treatment includes inhalation, sanitation bronchoscopy, physiotherapy.
If an underdeveloped lung is affected by an infectious disease, then its partial or complete removal is carried out. Depends on the degree of injuryinfection and the size of the underdeveloped area. Sometimes the patient has the entire left or right lung removed.
Treatment of cystic hypoplasia
This type of pathology is treated conservatively or surgically. The course of treatment of the cystic form of hypoplasia includes bronchoalveolar lavage, inhalation and postural drainage. But these methods bring only a temporary effect, alleviating the suffering of the patient. Various antibiotics are used for inflammation.
The main treatment is surgery. It is carried out in conditions where the patient is not threatened by infection or cardiovascular disease. Therefore, often before surgery, the patient is treated for inflammation with conservative methods.
During the operation, the affected areas of the lung are partially removed or the entire organ itself is removed.
What are the forecasts
The prognosis after this procedure is positive. Even with one lung, a person can live a long and quite normal life. True, throughout his life he will have to carefully monitor his he alth, beware of hypothermia and the likelihood of contracting viruses that cause colds. Mortality after surgery is only 1-2%, that is, a child with such a pathology has every right to a further full life.
Prevention
Prevention of pathologies that develop in utero lies entirely with the mother of the child. Underdeveloped lungs are the result of an inattentive and frivolous attitude towards pregnancy.by a woman.
In order for the fetus to develop correctly and fully, the expectant mother must regularly visit a doctor and take all prescribed tests. Especially on the content of certain hormones in the blood.
She should eat a strict diet, avoid fatty fried foods, foods with preservatives and artificial colors.
Do not drink alcohol or smoke during pregnancy.
A pregnant woman should walk at least 2 hours a day in order to improve the metabolism in the pelvic organs, especially the uterus.
She needs to keep a sleep schedule and sleep at least 8 hours a day to maintain a strong nervous system.
All this should be done not only during the period of bearing a child, but also during pregnancy planning. That is, 1-2 months before pregnancy. And if the future mother has diseases of the endocrine system or some other pathologies, then it makes sense to cure them first, and only then get pregnant.
