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Pneumothorax: Difference between revisions
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<section begin="radiology" />'''Pneumothorax''' (PTX) refers to the presence of air in the pleural space, between the lung and the chest wall. It may happen spontaneously or secondary to [[emphysema]], [[lung abscess]] or a fractured rib. | <section begin="A&IC" /><section begin="radiology" />'''Pneumothorax''' (PTX) refers to the presence of air in the pleural space, between the lung and the chest wall. It may happen spontaneously or secondary to [[emphysema]], [[lung abscess]] or a fractured rib. | ||
The pressure in the pleural cavity is normally negative to allow the lungs to expand in it. When it suddenly becomes filled with air the pressure in the pleural cavity will become equal with atmospheric pressure, causing the lung to collapse. | The pressure in the pleural cavity is normally negative to allow the lungs to expand in it. When it suddenly becomes filled with air the pressure in the pleural cavity will become equal with atmospheric pressure, causing the lung to collapse. | ||
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This tube is placed in the 4th or 5th intercostal space in the frontal axillary line (between the anterior and midaxillary lines). The tube is then connected to a water seal or a suction device. The water seal prevents air from leaking into the tube and allows for visualisation of air leaving the tube as bubbles in the water. A suction device produces negative pressure, literally sucking air out of the pleural cavity. | This tube is placed in the 4th or 5th intercostal space in the frontal axillary line (between the anterior and midaxillary lines). The tube is then connected to a water seal or a suction device. The water seal prevents air from leaking into the tube and allows for visualisation of air leaving the tube as bubbles in the water. A suction device produces negative pressure, literally sucking air out of the pleural cavity. | ||
For tension pneumothorax, emergency decompression is necessary. A large-bore needle is inserted into the 2nd intercostal space at the midclavicular line, which immediately releases the pressure. A chest tube is then placed as described above. | For tension pneumothorax, emergency decompression is necessary. A large-bore needle is inserted into the 2nd intercostal space at the midclavicular line, which immediately releases the pressure. A chest tube is then placed as described above.<section end="A&IC" /> | ||
Surgical treatment may be required in repeated spontaneous pneumothorax, or pneumothorax refractory to standard treatment. Surgery involves bullectomy to treat the underlying cause and applying pleurodesis (fusion of the parietal and visceral pleura, obliterating the space for air to enter). Pleurodesis may be performed mechanically, by literally sandpapering the pleura, or chemically, by applying talc or [[bleomycin]]. In case of both mechanical and chemical pleurodesis, the pleural membrane becomes inflamed, leading to fibrosis of both visceral and parietal pleura, causing them to adhere to each other, closing the pleural space. | Surgical treatment may be required in repeated spontaneous pneumothorax, or pneumothorax refractory to standard treatment. Surgery involves bullectomy to treat the underlying cause and applying pleurodesis (fusion of the parietal and visceral pleura, obliterating the space for air to enter). Pleurodesis may be performed mechanically, by literally sandpapering the pleura, or chemically, by applying talc or [[bleomycin]]. In case of both mechanical and chemical pleurodesis, the pleural membrane becomes inflamed, leading to fibrosis of both visceral and parietal pleura, causing them to adhere to each other, closing the pleural space. | ||
<noinclude>[[Category:Thoracic surgery]] | <noinclude>[[Category:Thoracic surgery]] | ||
</noinclude> | </noinclude> | ||