pneumothorax


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Related to pneumothorax: Tension pneumothorax

pneumothorax

(no͞omōthôr`ăks), collapse of a lung with escape of air into the pleural cavity between the lung and the chest wall. The cause may be traumatic (e.g., gunshot or stab wound), spontaneous (rupture due to disease or localized weakness of the lung lining), or environmental (extreme change in atmospheric pressure). The only symptom may be a sudden pain in the chest. Physical and radiological examination reveals characteristic signs of lung collapse. Simple pneumothorax of only one lung generally requires only rest; the break in the pleura usually heals quickly after collapse of the lung has taken place. In tension pneumothorax (where there is high intrapleural pressure), or if both lungs are collapsed, it is mandatory to remove the air from the pleural cavity immediately. An artificial pneumothorax is one deliberately induced, as in the treatment of tuberculosis of the lung before modern drugs became available, or in the diagnosis of lung disease.

Pneumothorax

 

a condition characterized by the accumulation of air or gas in the pleural cavity. Three types are distinguished according to origin: traumatic, spontaneous, and artificial.

Traumatic pneumothorax arises as a result of both open chest wounds, such as knife or gunshot wounds, and closed injuries, with no breaking of the skin; either type of injury is accompanied by rupture of a lung. In an open pneumothorax constant communication is maintained between the pleural cavity and air outside the body. Spontaneous pneumothorax arises as a result of sudden impairment of lung tissue, as with pulmonary emphysema or rupture of congenital pulmonary cysts. In some cases, there may be a flap of lung tissue covering the site of the rupture; this flap functions as a valve to prevent air from returning to the bronchus during exhalation. Such a valvular pneumothorax is accompanied by complete collapse of the lung, which then loses respiratory function, and by displacement of the heart, folding of major blood vessels, and circulatory disturbances.

The main symptoms of pneumothorax are pain in the chest and dyspnea. Auscultation reveals weak or absent respiration on the affected side. Air may also accumulate in the subcutaneous tissue of the chest, neck, face, or mediastinum with characteristic distention and crackling sensation upon palpation; these conditions are called subcutaneous emphysema and mediastinal emphysema. Complications of pneumothorax include pleurisy and hemopneumothorax, which results from the entry of blood into the pleural cavity. First aid for open pneumothorax requires prompt application of a bandage to cover the wound. In valvular pneumothorax the pleural cavity must be punctured and the air removed to prevent the lung from collapsing and the heart from shifting.

Artificial pneumothorax, the intentional introduction of air into the pleural cavity to compress the lung, was proposed by the Italian physician C. Forlanini in 1882. It is now used in the treatment of cavernous forms of pulmonary tuberculosis.

REFERENCE

Spontannyi (patologicheskii) pnevmotoraks. Moscow, 1973.

L. S. TONINSKII and V. A. FROLOV

pneumothorax

[¦nü·mō′thȯr‚aks]
(medicine)
The presence of air or gas in the pleural cavity.
References in periodicals archive ?
Among the 50 patients with spontaneous pneumothorax evaluated in the study, 41 were males (82%) and nine were females (18%), and the mean age was 33.
Because of the complications of TBB, the rate of pneumothorax was reported to be 6% and the rate of bleeding to be 0-4% in the series conducted in our country (6, 7).
In the case described, rigid bronchoscopy minimized the risk of aspiration of blood and detritus due to continuous flow of gas upward, and avoided the increase of the air leak through the pneumothorax thanks to limited airway pressures, making it a clear indication and utility.
Pneumothorax was divided into spontaneous pneumothorax (an intrapleural air collection in the absence of intubation, positive ventilation, or underlying pulmonary pathology) and secondary pneumothorax (with underlying lung pathology).
Prior to initiation of this study, Institutional Review Board approval was obtained to complete a retrospective medical record review for all patients undergoing thoracotomy or VATS for pneumothorax from January 1, 2000 to January 1, 2013 at the University of Kentucky Chandler Medical Center.
Secondary spontaneous pneumothorax is more serious than primary spontaneous pneumothorax because it decreases the pulmonary function of a patient with already compromised pulmonary function.
The possibility of coexisting pneumothorax and/or pneumomediastinum should also be kept in mind (7).
The incidence rate of primary spontaneous pneumothorax is increasing with recurrence rate of 20-60%, with Male to female ratios 2:1.
A pneumothorax disrupts the visceral-parietal interface, allowing the lung to naturally recoil and surrounding structures to relax.
Diagnosis of pneumothorax is confirmed by an upright posteroanterior chest radiograph, and characterized by a very thin, sharp white line that demarcates the visceral pleural edge as well as radiolucency and lack of lung markings peripheral to this line.
The 34-year-old McLaren driver revealed he suffered a pneumothorax - a partially collapsed lung - as a result of the accident in Melbourne but this had now healed.
It covers embryology, immunology, inflammation, genetics, transcriptomics and proteomics, pharmacokinetics, and experimental models, as well as the approach to patients, pleural fluid analysis, radiology, histology, cytology, effusions due to various causes, tumors, asbestos-related diseases, mesothelioma, pneumothorax, drainage techniques, pleurodesis, medical thoracoscopy, surgery, and gene therapy.