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Pneumothorax
Pneumothorax clinical manifestations
Pneumothorax is primarily caused by various factors, both internal and external to the lungs, leading to a significant accumulation of gas within the chest cavity. Patients exhibit symptoms such as chest tightness, breathlessness, including coughing, chest pain, and other related symptoms, which are collectively referred to as pneumothorax. Patients with pneumothorax can be classified into mild and severe types. Generally, after the onset of pneumothorax, patients who only experience symptoms like panting, chest tightness, chest pain, or coughing, but maintain stable blood pressure and heart rate, are considered to have a mild condition. However, if in addition to these respiratory symptoms, the patient clearly exhibits a drop in blood pressure, a decrease in oxygen saturation, or a reduction in heart rate, these conditions are considered severe and require urgent treatment.
How many days after pneumothorax can one smoke?
For patients with pneumothorax, it is advised to strictly quit smoking, as smoking greatly increases the recurrence of pneumothorax. Smoking leads to airway inflammation and respiratory bronchitis. Among male patients with pneumothorax, compared to non-smokers, smokers have a significantly higher incidence of pneumothorax, which is related to the degree of smoking. If the patient smokes less than half a pack, the recurrence rate of his pneumothorax is about 7 times higher. For moderate smokers, those who smoke between half a pack and one pack, the recurrence rate increases to 21 times. If one smokes a pack a day, the recurrence rate rises to 102 times, this is in males. In females, for those smoking less than half a pack, between half a pack and one pack, and more than one pack, the recurrence rates of pneumothorax become 4 times, 14 times, and 68 times respectively. Therefore, for both male and female patients with pneumothorax, smoking significantly increases the probability of recurrence. So, once pneumothorax is resolved, quit smoking as well, to prevent any future recurrences.
How is the fluid in pneumothorax drained?
Pneumothorax with effusion is mostly due to trauma or structural issues in the lungs themselves, leading to lung rupture, accompanied by intrathoracic hematomas, effusion, or pneumothorax. This condition is known as hydro-pneumothorax. Generally speaking, the treatment method depends on the severity of the hydro-pneumothorax. Usually, a mild case can be absorbed by the patient naturally. However, if the pneumothorax occupies more than 30% of the thoracic cavity, closed thoracic drainage should be implemented, along with the removal of pleural effusion for absorption to take place. Of course, the specific disease must be clearly identified, which might require repair, tumor resection, or anti-tuberculosis treatment to ultimately address the cause of the disease.
Causes of pneumothorax
The causes of pneumothorax vary with age. In young people, the condition often occurs in tall, thin individuals, somewhat akin to a balloon. We can liken the lung to a balloon: for shorter, heavier individuals, the balloon is rounder and experiences more uniform stress, whereas for tall, thin individuals, it's as if the balloon is being stretched vertically. Therefore, the tips of the balloon (or the lung) in tall, thin individuals are more prone to rupture. Additionally, for tall, thin individuals, the blood supply to the apical alveoli may not be as robust, making them more susceptible to micro-ruptures. Microscopic anatomical structures have also proven that there are tiny pores in the apical bubble tissues in these individuals. In older adults, the causes of pneumothorax are usually underlying lung diseases, such as chronic smoking, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and other conditions like tuberculosis or HIV infections can also lead to pneumothorax. Some cases are due to traumatic causes like physical injuries or stab wounds, which can lead to secondary or iatrogenic pneumothorax. In summary, while the causes of pneumothorax vary by age, in young people, it more commonly stems from being tall and thin. In older individuals, smoking, tobacco use, chronic bronchitis, and infections are more common causes.
The fastest method for spontaneous pneumothorax recovery.
Pneumothorax is mainly caused by various reasons that allow air inside the lungs to enter the pleural cavity, resulting in the accumulation of gas and the compression of the lung, reducing its volume. Clinically, for patients with lung compression not exceeding 30%, a conservative approach is typically chosen, which involves allowing the patients to heal naturally. For these patients who wish to accelerate their recovery, it is generally recommended to inhale high concentrations of oxygen, which can aid in the healing of the lungs. Additionally, it is important to increase nutrition and protein intake to enhance lung repair and recovery.
Foods to avoid with pneumothorax
We know that the lung tissue of a normal person is like a balloon. When breathing, this balloon expands and contracts, and there are about hundreds of millions of small structures in the lungs like balloons, which we call alveolar tissue. This structure also continuously expands and contracts, expelling carbon dioxide and inhaling oxygen. For certain reasons, such as infection or due to the body shape of tall, thin young people, or chronic obstructive pulmonary disease (COPD) and bronchitis in elderly people, this alveolar structure can rupture, causing some alveoli to merge into a large bulla. Of course, if the large bulla eventually ruptures, the break in this balloon-like surface will leak air into the pleural cavity, causing a pneumothorax. As for the nutrition from food, we believe that patients should not refrain from certain foods, but should instead increase their intake of protein, such as eating three to four egg whites daily. If worried about high cholesterol, discard the yolk, consuming only one yolk per day, but ensuring adequate protein intake. Therefore, for patients with pneumothorax, it is not about avoiding certain foods, but about eating more of those foods to which they are not allergic, such as shrimp and beef, rather than restricting their diet.
How many days does it take for a pneumothorax to heal?
The healing time for a patient with pneumothorax, or how many days it takes to heal, mainly depends on when the rupture on the lung heals. In younger patients who have good elasticity and strong healing capabilities, and whose nutrition keeps up, pneumothorax tends to heal relatively easily. Especially in younger patients experiencing pneumothorax for the first time, 70-80% may heal within two to three days because the gas escapes very quickly. Once the surface rupture on the lung heals, it can be cleared within a day, leading to healing. However, if the patient is older and also has conditions like tuberculosis or chronic bronchitis, the elasticity of the lungs is poorer, making healing difficult. Like a balloon without elasticity, if it gets a rupture, it may continue to expand, complicating the prediction of healing time. Regardless of age, whether the patient is young or old, if pneumothorax recurs a second time, it is advisable to seek aggressive treatment. Patients who have experienced pneumothorax twice are at more than a 70% to 80% risk of a third occurrence. This indicates a weak spot on the lung surface, similar to a wound on the hand. If a hand wound does not heal in a few days, it can be sutured. The same applies to lung surface wounds; as it is located inside the chest cavity, a thoracoscope is needed for suturing. Thus, in normal circumstances, pneumothorax could heal in a few days, but if repeatedly delayed, aggressive treatment might be necessary.
Pneumothorax CT manifestations
Pneumothorax CT manifestations, we know that there is a potential gap between the lungs and the chest wall in normal individuals, but normally, this gap or cavity is under negative pressure. This negative pressure ensures that the lungs are pressed tightly against the chest wall and the pleura, also containing a certain amount of lubricating fluid which allows for movement during inhalation without excessive friction causing pain. However, if due to some reason, such as a burst large or small pulmonary bullae, air enters this potential cavity or the pleural space, it is referred to as pneumothorax. Moreover, on a CT scan, it is distinctly visible that part of the chest cavity shows an area devoid of air-containing lung structures, indicating the absence of normal lung in this region. Normally on CT, a healthy lung appears like a sponge, so this phenomenon reveals sponge-like tissue, referred to as lung texture. But when air enters, the pressure from the air can compress the lung, causing it to collapse, similar to a deflating balloon. In addition, part of the CT imaging presents as dark areas around the periphery where lung textures are absent or cavities appear, referred to as pneumothorax.
Pneumothorax recurrence symptoms
We know that normally there is no air in the pleural cavity, only a small amount of fluid or lubricant exists. However, in certain people, such as those who often smoke, tall and thin young people, and patients with chronic bronchitis, the alveoli in their lungs tend to be more fragile and can easily rupture. People experiencing a pneumothorax for the first time might feel this during certain situations like after a cold, coughing, sneezing, or playing sports, which can lead to a recurrence of the pneumothorax. Early symptoms of a recurrence, due to only a small amount of air compression, might not be very uncomfortable, just a slight sense of difficulty breathing. As the pneumothorax increases, symptoms like chest pain and difficulty breathing can develop. Therefore, the symptoms of a recurring pneumothorax are not identical each time, but there is a pattern; the severity can range from mild breathing difficulty to severe respiratory distress and chest pain.
How to check for hemothorax and pneumothorax?
Actually, the examination methods for hemothorax and pneumothorax are quite simple. From their definitions, we know that hemothorax means the abnormal presence of blood in the pleural cavity, and pneumothorax means the presence of gas in the pleural cavity where it shouldn't be. Therefore, the simplest examination is an X-ray, a standard frontal and lateral chest X-ray, which usually costs about 52 yuan, can detect whether a patient has pneumothorax. As for hemothorax, of course, it involves the use of a syringe. After injecting some lidocaine local anesthesia into the patient, if blood is withdrawn from the pleural cavity, then it indicates a hemothorax. Thus, the first step in examining for hemothorax and pneumothorax is to perform an X-ray to check for the presence of gas. If gas is detected, then it is pneumothorax. If liquid is found, a syringe under ultrasound guidance can be used to withdraw it. If the withdrawal yields fluid, it indicates pleural effusion; if blood is drawn, then it indicates hemothorax.