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Pneumothorax
Is pneumothorax the same as emphysema?
Pneumothorax and emphysema can both manifest symptoms such as chest tightness, difficulty breathing, and coughing. However, is pneumothorax the same as emphysema? Pneumothorax and emphysema are two different diseases. Simply put, pneumothorax is a pleural disease caused by a rupture of the pleura, while emphysema is a disease of the airways. When a lung is imaged for pneumothorax, the film shows lung compression. It is possible to see the external boundary of the compressed lung where pneumothorax is present, with no lung markings. In the case of emphysema, imaging shows that the thoracic cage is expanded, with widened intercostal spaces, and increased translucency in both lung lobes. Therefore, the differences between pneumothorax and emphysema are significant, and they are not the same disease.
Pneumothorax is caused by what?
Pneumothorax is caused by the entry of air into the pleural cavity, leading to a series of changes. Pneumothorax can be divided into spontaneous and traumatic pneumothorax. Spontaneous pneumothorax occurs without trauma or other causes, while traumatic pneumothorax is caused by direct or indirect trauma to the pleura. Spontaneous pneumothorax can be further categorized into primary and secondary pneumothorax. Patients with primary spontaneous pneumothorax do not have underlying lung disease, whereas secondary pneumothorax is a complication of lung disease, commonly seen in chronic obstructive pulmonary disease. Traumatic pneumothorax includes iatrogenic pneumothorax, which occurs during diagnostic and therapeutic procedures.
What position should be taken for pneumothorax?
Pneumothorax occurs when the pleura ruptures and gas enters the pleural cavity, often compressing the lung tissue. Patients may experience symptoms such as chest pain, chest tightness, and coughing. The choice of lying position for patients with pneumothorax depends on the severity of the pneumothorax and the degree of chest tightness. If the pneumothorax is mild and the symptoms are not obvious, the patient can lie flat. If there is significant chest tightness, a semi-recumbent position may be adopted. If the chest tightness is severe and the patient has significant difficulty breathing, they often assume a sitting position, frequently struggling to breathe, sweating profusely, and may even experience respiratory failure, requiring immediate attention.
Symptoms of rib fracture and pneumothorax
Patients who have suffered a rib fracture typically experience localized pain which affects their ability to turn, bend, or perform normal movements such as breathing and coughing. If the rib fracture is accompanied by a pneumothorax, symptoms like chest tightness and breathlessness often occur. Diagnosing a rib fracture with pneumothorax requires an assessment of the patient's clinical symptoms along with various supportive examinations. For example, a chest CT scan can confirm the presence of a pneumothorax and determine the severity of the condition. In cases where the pneumothorax is severe and the lung compression exceeds one-third, it is necessary to actively pursue thoracic closed drainage surgery as treatment.
What department should I go to for pneumothorax?
What department is pneumothorax treated in? For pneumothorax, we commonly see patients first in the emergency department, as the onset of pneumothorax is generally very sudden and the condition can be quite severe. The patient may suddenly experience difficulty breathing, and in most cases, this breathing difficulty is severe. Therefore, patients typically start by seeing the emergency internal medicine department. The doctors there will assess the patient’s condition and will consult with thoracic and cardiovascular surgery and respiratory medicine. If a closed thoracic drainage tube is needed, our surgeons will immediately perform the drainage. If the patient can be treated conservatively, they are usually then transferred to either respiratory medicine or thoracic and cardiovascular surgery for further treatment.
Pneumothorax pleurodesis: what are the advantages and disadvantages?
Pleurodesis for pneumothorax involves injecting a sclerosant into the pleural cavity to induce a sterile inflammation, causing adhesion of the parietal and visceral pleurae, thereby eliminating the pleural space. This can be used to treat pneumothorax. The benefits include a high success rate, simple operation, and low recurrence rate. The downside is that there can be adverse reactions, the most common being chest pain and fever; severe cases may cause acute respiratory distress syndrome. Therefore, extra care is needed during the pleurodesis procedure.
What are the main signs of pneumothorax?
If it is a small amount of pneumothorax, the physical signs are generally not obvious, especially when patients with emphysema develop pneumothorax, it is difficult to detect any signs. However, when a larger amount of pneumothorax occurs, inspection will reveal that the affected side of the chest is bulging and respiratory movements are reduced. Upon palpation, the trachea usually shifts towards the healthy side, tactile fremitus on the affected side is reduced, percussion results in hyperresonance or tympany, and auscultation shows reduced breath sounds, which can disappear in severe cases.