Pneumothorax🫁 - Clinical Surgery By Dr Pawan Khandari скачать в хорошем качестве

Pneumothorax🫁 - Clinical Surgery By Dr Pawan Khandari

📌 𝐅𝐨𝐥𝐥𝐨𝐰 𝐨𝐧 𝐈𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:-   / drgbhanuprakash   📌𝗝𝗼𝗶𝗻 𝗢𝘂𝗿 𝗧𝗲𝗹𝗲𝗴𝗿𝗮𝗺 𝗖𝗵𝗮𝗻𝗻𝗲𝗹 𝗛𝗲𝗿𝗲:- https://t.me/bhanuprakashdr Pneumothorax Introduction ____________ Pneumothorax is a condition in which air accumulates in the pleural space, the potential space between the lung and chest wall. This air can lead to a partial or complete collapse of the lung on the affected side. Pneumothorax can arise spontaneously, as a result of trauma, or due to medical procedures. The condition can vary in severity, from mild and self-limiting to life-threatening, depending on the amount of air involved and the underlying health of the patient. Types of Pneumothorax ________________________ Spontaneous Pneumothorax Primary Spontaneous Pneumothorax (PSP): Occurs in people without any underlying lung disease. It is often associated with the rupture of small air-filled sacs called blebs or bullae on the lung surface. PSP is more common in tall, thin young men and smokers. Secondary Spontaneous Pneumothorax (SSP): Occurs in people with pre-existing lung conditions such as Chronic Obstructive Pulmonary Disease (COPD), cystic fibrosis, or tuberculosis. SSP is usually more serious than PSP due to the compromised lung function in these patients. Traumatic Pneumothorax Caused by blunt or penetrating injury to the chest, such as from a car accident, fall, or stab wound. Traumatic pneumothorax can be associated with other injuries like rib fractures or damage to the major blood vessels. Iatrogenic Pneumothorax This type occurs as a result of medical procedures, such as lung biopsy, central venous catheter insertion, or mechanical ventilation. Although it is often an unintended complication, prompt recognition and treatment are essential. Tension Pneumothorax A life-threatening condition where air enters the pleural space during inhalation but cannot escape during exhalation. This leads to increasing pressure in the chest, compressing the lungs and major blood vessels, and can quickly result in cardiovascular collapse. Pathophysiology Pneumothorax occurs when air enters the pleural space, either from a breach in the lung tissue, chest wall, or through iatrogenic means. The presence of air in the pleural space disrupts the negative pressure that normally keeps the lungs inflated, leading to lung collapse. Air Entry Mechanisms Rupture of Blebs/Bullae:In PSP, small, weakened areas on the lung surface can spontaneously rupture, allowing air to leak into the pleural space. Traumatic Injury: Direct trauma to the chest can puncture the lung or chest wall, creating a passage for air to enter the pleural space. *Iatrogenic Causes:* Medical procedures that inadvertently puncture the lung or pleura can introduce air into the pleural space. Clinical Presentation Symptoms Sudden Onset of Chest Pain: Often sharp and localized to the affected side. The pain can worsen with breathing or coughing. Shortness of Breath: Ranges from mild to severe, depending on the size of the pneumothorax and the patient’s underlying lung function. Cough: A dry, hacking cough may occur, especially in spontaneous pneumothorax. Signs Decreased or Absent Breath Sounds: On the side of the pneumothorax, breath sounds may be diminished or absent. Hyperresonance: Percussion of the affected side of the chest may produce a hyperresonant sound due to the presence of air. Tracheal Deviation:In tension pneumothorax, the trachea may be pushed away from the affected side. Distended Neck Veins: Due to increased intrathoracic pressure, particularly in tension pneumothorax. Management Observation Small, asymptomatic pneumothoraces can be managed with observation alone, especially in stable patients. Follow-up imaging is necessary to ensure resolution. Needle Aspiration For larger or symptomatic pneumothoraces, needle aspiration may be performed to evacuate the air. This procedure is often effective in primary spontaneous pneumothorax. Chest Tube Insertion A chest tube (thoracostomy) may be required if aspiration fails or if the pneumothorax is large. The tube allows continuous drainage of air, helping the lung to re-expand. Surgical Intervention Video-Assisted Thoracoscopic Surgery (VATS): Used to treat recurrent pneumothorax or persistent air leaks. VATS allows the surgeon to remove blebs or perform pleurodesis (a procedure that seals the pleural space to prevent recurrence). *Open Thoracotomy:* Rarely needed, reserved for complicated or recurrent cases where less invasive methods have failed. Tension Pneumothorax Immediate Needle Decompression: This is a medical emergency. A needle is inserted into the pleural space to release trapped air, followed by chest tube insertion. #Pneumothorax #ClinicalSurgery #ChestTrauma #MedicalEmergency #NEETPG #USMLE #FMGE #SurgeryNotes #LungHealth #MedicalEducation #ThoracicSurgery