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Pneumothorax: Difference between revisions
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== Diagnosis and evaluation == | == Diagnosis and evaluation == | ||
The diagnosis of pneumothorax is based on a simple [[chest x-ray]], which will show a | The diagnosis of pneumothorax is based on a simple [[chest x-ray]], which will show a thin white line (the visceral pleura) at the border of the collapsed lung, as well as absent lung markings distal to the pleural line. The length from the chest wall to the visceral pleura on the x-ray shows the "size" of the PTX. The deep sulcus sign refers to a dark and deep costophrenic angle on the affected side. X-ray and [[CT]] may also show bullae. | ||
Suspected tension pneumothorax is a clinical diagnosis does not undergo imaging. They proceed immediately to treatment. Should a chest x-ray be made, a mediastinal shift and tracheal deviation toward the contralateral side will be present. | Suspected tension pneumothorax is a clinical diagnosis does not undergo imaging. They proceed immediately to treatment. Should a chest x-ray be made, a mediastinal shift and tracheal deviation toward the contralateral side will be present. The ipsilateral diaphragm may be flattened or inverted. | ||
== Treatment == | == Treatment == | ||
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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> | <noinclude>[[Category:Thoracic surgery]] | ||
</noinclude> | |||