Pneumothorax

Pneumothorax in children of the first days of life most often occurs as a result of rupture of lung tissue during artificial ventilation. The cause of lung rupture can also be increased intrabronchial pressure that occurs during labor, or the developmental defect of the lungs (cysts, bulls). Perhaps the development of pneumothorax and in the complicated course of inflammatory processes in the lungs, for example, the breakthrough of the lung abscess into the pleural cavity with the formation of pyopneumotorax.

The clinical picture is determined by the nature and severity of the pathological process in the lungs and the severity of the intrathoracic tension. In the case of strained (valve) pneumothorax, the child's condition progressively worsens, anxiety, difficulty breathing, shortness of breath, cyanosis appear and rapidly increase. A boxed percussion shade of sound is revealed, the boundaries of the heart and mediastinum are shifted in the direction opposite to tension; Respiratory noises above the side of the lesion are not listened to, there is a marked tachycardia. Radiographically determine the collapse of the lung, the displacement of the boundaries of the heart and mediastinum in a healthy way. With ruptures of the lung tissue can also develop emphysema mediastinum. In these cases, the puffiness of the face, subcutaneous crepitus on the neck and trunk up to the scrotum are added to these symptoms. On the roentgenogram, a pneumomediastinum is detected, the borders of the thymus gland are clearly contoured.

Treatment pneumothorax conservative: pleural puncture, drainage of the pleural cavity. In severe cases with ineffectiveness of these manipulations, bronchoscopy and temporary occlusion of the bronchus of the damaged lobe are performed. In the presence of increasing emphysema of the mediastinum, surgical intervention is shown, consisting in draining the anterior mediastinum with a silicone tube through a cut above the sternum incision.

The prognosis usually depends on the severity of the symptoms of the birth trauma, the initial condition of the lung tissue at the time of pneumothorax development, the timeliness of the delivery of therapeutic measures, especially with its valve nature.