Piopevneumotorax

Piopnevmotorax accumulation of pus and air in the pleural cavity with varying degrees of collapse of the lung. Most often, the disease has a meta- and parapneumonic origin and occurs as a result of a breakthrough in the lung abscess with the formation of a bronchopleural fistula. Traumatic genesis is possible. At the heart of pyopneumotorax always lies the infectious beginning (staphylococcus and streptococcal destruction of the lungs, Pseudomonas aeruginosa, anaerobes, less often pneumococci).

Symptoms, course. There are 3 clinical forms. 1. Acute, rapidly emerging: a picture of cardiac collapse, a sudden boxed sound with percussion over the former dullness, progressive pneumothorax (sometimes stressful); The clinic of pseudo-abdominal syndrome is not excluded. 2. Soft form: the breakthrough of the abscess into a closed, enclosed space. Moderate pain in the side. Inversion of physical signs, deterioration of the patient's condition with this or that form of destruction of lung tissue (even relatively smoothly with the current pneumonia) always serve as an excuse to search for the arisen pneumothorax. 3. The erased form - the moment of a breakthrough into the pleural cavity is difficult to catch. Important nuances are: dynamic observation of the patient's condition and regular x-ray control.

Treatment in a surgical hospital. In acute pyopnevmotorax, urgent drainage of the pleural cavity is shown, most often in the third to fourth intercostal space along the mid-incisional line with the aim of resolving the strained pneumothorax, and only then - adequate drainage for the evacuation of pus.

The prognosis is serious.