Pneumothorax spontaneous

Pneumothorax spontaneous - loss of negative pressure in the pleural cavity, accompanied by partial or total collapse of the lung due to communication with the external environment with the integrity of the chest wall. When the new incoming air is delayed, a strained (valve) pneumothorax arises in the pleural cavity, rapidly leading to a massive collapse of the lung and displacement of the mediastinal organs. Characteristic symptoms are a sudden intense pain in the food cavity, often occurring in the midst of complete health, lack of air, cyanosis, tachycardia. Possible reduction in blood pressure, lack of tactile voice jitter, percussion and box sound, respiratory noise reduced or disappear. Respiratory failure can pass without the permission of pneumothorax. The final diagnosis is determined by X-ray examination. Spontaneous pneumothorax can be primary and secondary. Primary arises from the breakthrough of subpleural emphysematous bullae, more often in the apex of the lungs. Usually these are high-growth patients with an inappropriately smaller body weight. Pneumothorax develops at rest, less often with exercise. Smokers are more prone to spontaneous pneumothorax. The probability of relapse without pleurodesis is approximately 50%. Secondary spontaneous pneumothorax occurs more frequently on the background of chronic obstructive pulmonary diseases (tuberculosis, silicotuberculosis, sarcoidosis, bronchial asthma, pulmonary infarction, rheumatoid diseases, echinococcosis, berylliosis). The clinic of secondary spontaneous pneumothorax is more severe.

The treatment of spontaneous pneumothorax has two purposes: the removal of air from the pleural cavity and a reduction in the likelihood of relapse. The first treatment aid is puncture of the pleural cavity and aspiration of air through the puncture in the third to the fourth intercostal space along the mid-clavicular line and after that the drainage according to Bylau, especially with intense pneumothorax, the use of anesthetics. For the prevention of recurrence, pleurodesis is used by sclerosing agents, in particular tetracycline at a dose of 20 mg / kg intrapleural when the lung is expanded.

Menstrual pneumothorax is associated with the menstrual cycle in women over 25 years of age. Occurs in the first 48 hours after the onset of menstruation. The origin is unknown. To treat use of drugs that suppress ovulation. Otherwise, thoracotomy pleurodesis. Neonatal pneumothorax is more often observed in newborns, about 1-2% (with clinical symptoms in 0.5%), 2 times more often in newborn boys, usually in full-term and tolerated children. The reason is related to mechanical problems of the first lung dilatation, as well as respiratory distress syndrome. Diagnostics X-ray. With clinical symptoms - drainage of the pleural cavity. Hospitalization in a surgical hospital.

The prognosis for primary spontaneous pneumothorax is favorable, with secondary-conditioned by the course of the underlying disease.