Pneumothorax is a dangerous disease that, if not diagnosed and treated incorrectly, can lead to a patient's death. Therefore, it is very important to consult a doctor at the first signs of pathology and take an x-ray of pneumothorax, so that it will be possible to detect the disease in time and save the patient's life.
Classification of pathology
Types of pneumothorax:
- Spontaneous. This type of pneumothorax occurs mainly due to damage to the lung tissue. The disease can be primary and secondary. The X-ray image of spontaneous pneumothorax is characterized by the absence of a pulmonary pattern. The organ itself straightens out and takes the correct position during inhalation, and when exhaling, you can again see its pathological location.
- Tense. This type of pneumothorax is also characterized by the absence of a pulmonary pattern, as well as a deviation of the upper part of the diaphragm and a shift of the mediastinum towards a he althy organ.
- Cloak-like. This type of pathology develops secretly and in most cases is detected during fluorography, which is carried out for preventive purposes. If pneumothorax is suspected, diagnosis should be carried out only in an upright position, since all other positions will not show proper information, as a result of which the doctor will not be able to make a correct diagnosis.
- Left side. On the X-ray of the left-sided pneumothorax, the visceral edge of the pleura is clearly visible, which is formed in the form of a thin white strip, separated from the parietal sheet by a gas or air space.
Pneumothorax in tuberculosis
Pneumothorax is one of the complications of tuberculosis, but it develops extremely rarely. Pathology is formed spontaneously when the integrity of the pleural sheet, located in the inner part of the lung, is violated. Such a lesion can lead to the formation of a fistula in the pleural cavity, as a result of which air enters the lung.
Other reasons
There are a number of other reasons that can also trigger the development of pneumothorax:
- infectious diseases;
- chronic respiratory diseases – bronchitis, asthma;
- malignant tumors and metastases from other affected organs;
- purulent foci of lung tissue;
- a sharp change in climatic conditions.
Symptomatic manifestations
Signs of pneumothorax depend onon the severity of the underlying disease, in most cases it is tuberculosis. If the disease proceeds in a long latent stage, then signs of pneumothorax may not be detected, since in most cases they are attributed to tuberculosis. However, if tuberculosis is not properly treated or the disease progresses, then specific signs may appear.
Pain is the main symptom of pneumothorax development. The pain may be compressive or stabbing in nature and develops in the affected part of the chest. In most cases, the pain syndrome is localized in the upper chest, but sometimes it is given to the lower back, arm, shoulder, abdomen or neck. Along with pain, the following unpleasant symptoms of pathology occur:
- Arrhythmia, breathing becomes deeper and faster.
- Severe dry cough.
- Shortness of breath that increases as the pathology progresses.
- From an excess of carbon dioxide in the circulatory system, the skin takes on a bluish tint.
- With pneumothorax, the patient experiences compression in the chest.
- Due to the development of pneumothorax, the patient may begin to panic and anxiety.
Diagnostic measures
X-ray of pneumothorax is the most informative diagnostic method in this case. It is possible to determine the pathology with the help of modern fluoroscopy devices that do not cause any harm to the patient. An x-ray is usually taken in frontal and lateral projections, after which a description is madepneumothorax on x-ray.
Alternative diagnostics
If the X-ray photo of pneumothorax does not show the full picture of what is happening, the doctor may prescribe an ultrasound examination of the lung and blood gasometry as additional diagnostic measures.
Computed tomography of the lung is an alternative to X-ray, which is best done in the following cases:
- In order to identify what was the true cause of the development of pneumothorax. This can be determined using emphysematous bullae, which are detected during diagnosis.
- If it is necessary to detect localization of a non-extensive pneumothorax.
- Determine the cause of the secondary development of pathology.
After carrying out these diagnostic methods, along with an x-ray, the doctor gets a complete picture of how badly the organ is affected.
When air accumulates in the upper part of the lung, fluoroscopy is performed, that is, the diagnosis is made in real time by examining the patient from several sides. During the rotation of the patient, the doctor determines the movement of air in the lung. Such an analysis is carried out if the pressure in the patient's chest does not change, despite the confirmation of pneumothorax. If the disease is not detected in time, then the pressure will increase greatly, a strong collapse of the lung will appear, resulting in a lack of oxygen in the human body.
Classification of pneumothorax
In the process of diagnosis, three types of pathology are revealed, each of which has a number of features:
- Open. With an open pneumothorax, a channel is formed in the patient, which connects the pleural cavity and the external environment. At the same time, the pressure in the chest is equal to atmospheric pressure, as a result of which the lung tissue begins to subside and the organ ceases to function. On an x-ray photo of an open pneumothorax, you can see that the lung tissue is compressed, the dome of the diaphragm becomes flat, and the middle wall of the lung is shifted to the side. The prognosis for open pneumothorax is poor.
- Closed. With a closed pneumothorax, the movement of air to the chest organs is much more difficult. Often, there may be no damage to the pleural cavity, but in some cases it is covered with particles of tissue, small blood clots, or pus. On the X-ray of a closed pneumothorax, there is no pulmonary pattern, and the edges of the organ are clearly visible. The closed type of pulmonary pneumothorax responds well to therapy and does not leave behind any consequences or complications.
- Valved. This type of pathology is characterized by the formation of a valve that lets air into the lung, but does not release it. In this regard, the internal pressure rises greatly and becomes much greater than atmospheric pressure, while the patient's vessels of the heart and trachea are compressed, as a result of which breathing becomes very quick and the person falls into a state of shock. In the X-ray picture of pneumothorax of the lungs of the valvular type, clearlyit can be seen that the middle wall of the lung is displaced to the side opposite to that in which the pathological process began to develop. A characteristic feature of this type of pathology is that the degree of danger to human life depends on the speed at which atmospheric air enters the lungs.
What is the importance of diagnosis?
Since the pathology develops rather slowly, the X-ray can reveal the initial stage of pneumothorax. This can save the patient's life, as in the event of a lung rupture, doctors have very little time to do it.
X-ray for suspected pneumothorax is one of the main methods for diagnosing pathology. One of the basic manifestations of the disease is the air in the pleural cavity. X-ray of a pneumothorax does not reveal a lung pattern. Along with this, the presence of air in the lung is manifested by a white spot. Due to the specificity of the manifestations on the X-ray of pneumothorax, it is possible to determine the type of pathology, which can be classified as open, closed and valvular pneumothorax.
In addition to radiography, the doctor performs a visual examination of the patient, and blood gasometry and ultrasound may also be required.
Basic Principles of Therapy
Therapy of pneumothorax resulting from tuberculosis is complex. During treatment, the doctor performs chemotherapy and puncture of the pleural cavity. During the puncture, all accumulated air is removed from the lungs.
If tuberculosisoccurs at an early stage, then the patient may develop an artificial pneumothorax, in which 300 ml of gas is injected into the organ. Thanks to this procedure, the lung quickly recovers and expands.
When a pneumothorax is detected, treatment should be started immediately, otherwise it can lead to rapid progression of the pathology and the development of irreparable complications.
Consequences of pneumothorax
With inadequate and untimely therapy, the disease can go into a neglected form, as a result of which the affected part of the chest begins to protrude, becomes less mobile and cannot properly participate in the respiratory process.
If a pneumothorax develops as a result of an injury, then emphysema may appear under the skin.
The disease should be diagnosed and treated at an early stage, otherwise the life of the patient may be in jeopardy. The slow development of pathology can lead to the following consequences:
- inflammation of the pleural cavity;
- compaction of lung tissue;
- hemorrhage;
- unilateral or bilateral pneumonia;
- accumulation of fibrin in the tissues of the pleura;
- impaired respiratory function.
With all this, the lung tissue is greatly weakened and even the slightest physical activity (cough) can lead to rupture of the organ. When a lung ruptures, the patient has very little chance of surviving, since the hemodynamics of the heart is severely disturbed, heart failure and sudden stop appear.body.
Pneumothorax cannot be determined without concomitant diagnostics, based only on the patient's complaints and physiological examination. It is possible to determine and establish a diagnosis only through an X-ray examination.
