scholarly journals Spontaneous pneumothorax: some aspects of etiology, pathogenesis and treatment (literature review)

2021 ◽  
Vol 24 (1) ◽  
pp. 37-46
Author(s):  
Alexandr I. Bezhin ◽  
Maksim E. Kletkin ◽  
Iryna V. Litvinenko ◽  
Anna A. Fisyuk
Keyword(s):  
Surgical Treatment ◽  
Spontaneous Pneumothorax ◽  
Pleural Cavity ◽  
Autologous Blood ◽  
Chronic Obstructive ◽  
Fibrin Gel ◽  
Obstructive Pulmonary Disease ◽  
Surgical Interventions ◽  
Video Assisted ◽  
Emphysematous Lung

The review article discusses the prevalence, etiology, pathogenesis, and treatment of spontaneous pneumothorax. The vascular, mechanical, obstructive, infectious, and enzymatic theories of the occurrence of emphysematous lung changes as the main cause of developing spontaneous pneumothorax are described; the role of smoking as the main etiological factor and its influence on the recurrence rate of spontaneous pneumothorax are studied. The issues of choosing primary cure tactic are considered. The effectiveness of conservative treatment, puncture and drainage of the pleural cavity as methods of treatment and pleurodesis for the prevention of recurrences of spontaneous pneumothorax are described. A comparativeassessment of various methods of pleural cavity obliteration is given: chemical pleurodesis (by sterile talc, minocycline, povidone-iodine, 50% glucose solution, autologous blood and its components, autologous adipose tissue, pseudomonas aeruginosa sensitive hemagglutinin, picibanil), apical pleurectomy, pleuroabrasion. The experience of using YAG-ND and CO2 as methods of physical pleurodesis, intraoperative Staple Line Coverage with polyglyconic acid and fibrin gel is described. The necessity of active surgical tactic in the treatment of patients with spontaneous pneumothorax developed on the base of undifferentiated connective tissue dysplasia has been substantiated. The advantages, disadvantages, indications and contrindications to different ways of surgical treatment (thoracotomy, video-assisted minithoracotomy, thoracoscopy) are discussed. The strategy for choosing treatment methods depending on the volume of pneumothorax, the severity of bullous changes, the presence of concomitant diseases, chronic obstructive pulmonary disease, and the value of the Charlson comorbidity index is considered. The expediency of using video-assisted minithoracotomy as the safest and most effective method of surgical treatment of spontaneous pneumothorax has been substantiated. The effectiveness of surgical interventions depending on the timing of their implementation is considered.

scholarly journals POSSIBILITIES OF USING MINIINVASIVE CATHETER TECHNOLOGIES IN THE TREATMENT OF LUNG BLEEDING

2019 ◽  
Vol 6 ◽  
pp. 41-48
Author(s):  
Kateryna Ponomarova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Surgical Treatment ◽  
Pulmonary Disease ◽  
High Efficiency ◽  
Bronchial Artery ◽  
Pulmonary Hemorrhage ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Bronchial Arteries ◽  
Obstructive Pulmonary Disease

Aim – improve the results of the treatment of patients with pulmonary bleeding through widespread use of endovascular surgery methods for hemostasis. Materials and methods. Method of endovascular embolization of bronchial arteries is widely used in our clinic SI «Zaycev V. T. Institute of General and Emergency surgery of NAMS of Ukraine» not only as independent surgery in patients with LB, but also as way of preparation of patients with lung bleeding for planned thorax surgery. The most of the often spread nosological forms complicated by bleeding in our research were polycystic lung disease, chronic obstructive pulmonary disease, bronchiectasis disease, community-acquired pneumonia. Indications to the сatheter embolization procedure of bronchial arteries are the following: conservative treatment failure, hemoptysis in patients with bilateral inflammatory processes who was not prescribed surgical treatment for a range of reasons, absence of gross structural changes, lung resection, mainly in patients with oncologic lung injury, at massive and life-threatening profuse bleedings as a mean of temporary or constant hemostasis. Discussed treatment method is applied only in bleeding or within a 6 – 12 hour after its treatment. Successful result in embolization can be obtained in 79–99 %. Results. As a result of complete physical examination of patients with LB, it has been established that lung hemorrhage was the result of obstructive bronchitis in 14 patients (42 %), there was chronic obstructive pulmonary disease in 7 (21 %) patients and bronchiectasis was diagnosed in 6 (18 %) patients. In 2 (6 %) patients pulmonary hemorrhage was caused by community-acquired pneumonia. Central lung cancer was detected in 4 (12 %) patients. Conclusion. Therefore bronchial artery angiography gives high efficiency in solving the problem of hemostasis in oncological and nonspecific lung diseases, for determination of localization and source of bleeding. Endovascular occlusion of bronchial arteries in pulmonary hemorrhage permits: – to elaborate diagnosis because of the presence of specific angiographic signs of malignant tumour; – to perform effective endovascular hemostasis; – to gain time for stabilization the patient with the aim of planned surgical treatment.

Emphysema

Chest Imaging ◽  
2019 ◽  
pp. 325-329
Author(s):  
Travis S. Henry ◽  
Brent P. Little
Keyword(s):  
Lung Disease ◽  
Pulmonary Function Tests ◽  
Disease Process ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Common Disease ◽  
Obstructive Pulmonary Disease ◽  
Cystic Lung ◽  
Emphysematous Lung ◽  
Different Parts

Emphysema is the abnormal, permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of alveolar walls, but without obvious fibrosis. Chronic obstructive pulmonary disease (COPD) is a spectrum of obstructive lung diseases that includes emphysema and chronic bronchitis – diseases that frequently coexist, especially in smokers. Emphysema is an extremely common disease and in most cases the diagnosis is established with clinical data including pulmonary function tests (PFTs). CT may be helpful for clarifying the diagnosis in mild cases or if another disease process (such as interstitial lung disease) is suspected. The three different types of emphysema (centrilobular, paraseptal, and panlobular) affect different parts of the secondary pulmonary lobule and are easily distinguished on CT. Emphysema distorts the normal lung anatomy and can cause superimposed processes (e.g. pneumonia or pulmonary edema) to look atypical on chest radiography and CT. Similarly, lung cancer may have an unusual morphology when it arises within emphysematous lung. Cystic lung disease and honeycombing in pulmonary fibrosis should not be confused with emphysema. Cysts and honeycombing have defined walls on CT, whereas centrilobular emphysema manifests as areas of low attenuation without perceptible walls.

scholarly journals Experience of treatment of endometriosisrelated pneumothorax

2017 ◽  
Vol 176 (3) ◽  
pp. 56-60
Author(s):  
V. G. Pishchik ◽  
A. D. Obornev ◽  
M. A. Atyukov ◽  
A. S. Petrov ◽  
A. I. Kovalenko
Keyword(s):  
Surgical Treatment ◽  
Hormone Therapy ◽  
Spontaneous Pneumothorax ◽  
Pleural Cavity ◽  
Reproductive Age ◽  
Control Group ◽  
Visual Examination ◽  
Women Of Reproductive Age ◽  
Course Of Disease

OBJECTIVE. The article analyzed the experience of treatment of endometriosis-related pneumothorax (ERP). MATERIAL AND METHODS. The diagnosis of ERP was detected in 30 women at the period from 2004 to 2015. A control group consisted of 149 women. RESULTS. Statistically significant differences associated with presence of ERP were the elder age, right-side localization and recurrence course of disease. Diaphragmatic fenestrations and endometriotic ectopy and their combinations were specific findings in ERP-group. This group of patients characterized by frequent recurrences and higher rate of complications. The most effective method of treatment of ERP was diaphragm resection with pleurectomy and hormone therapy from 3 to 6 months after surgery. CONCLUSIONS. Endometriosis-related pneumothorax could cause up to 34 % cases of spontaneous pneumothorax in women of reproductive age. Diaphragmatic fenestrations and endometriotic lesions were specific signs of EAP. Direct visual examination of the pleural cavity was inevitable for reliable diagnostics of the disease. Surgical treatment of ERP was determined by higher rates of complication and recurrence. Postoperative hormone therapy could significantly improve the results of surgical treatment of ERP.

scholarly journals EVALUATION OF THE POSSIBILITY OF USING CORYOLIS VITRATOMYER IN THE DIAGNOSIS OF PULMONARY DAMAGE IN VICTIMS WITH FIRE PENETRATION EARLY WOUNDS

2021 ◽  
pp. 52-55
Author(s):  
E. A. Chernyavsky ◽  
Yu. V. Bunin ◽  
V. V. Negoduyko ◽  
R. M. Mikhailusov ◽  
E. M. Khoroshun ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pleural Cavity ◽  
Gunshot Wounds ◽  
Early Complications ◽  
Video Assisted ◽  
Chest Injuries ◽  
Coriolis Flowmeter ◽  
Lung Injuries ◽  
Pulmonary Damage ◽  
Air Discharge

Summary: The aim of the study was to determine the dependence of the volume of air discharge from the pleural cavity on the choice of surgical treatment in patients with penetrating chest injuries. Materials and methods. Of the 39 observations, video-assisted thoracoscopy (VATS) was performed in 24 patients due to existing hemothorax. Results and their discussion. Among patients with penetrating chest injuries and early complications in the form of isolated pneumothorax on the first day, VATS was performed in three cases, due to increased air discharge from the pleural cavity. On the second and third day, 3 and 1 patient needed PBX, respectively. The article presents the experience of using a Coriolis flowmeter to objectify the diagnosis of lung injuries in victims with gunshot wounds penetrating the chest. Depending on the speed and volume of air discharge from the pleural cavity, the dynamics can be determined by the tactics of treatment. Conclusions: 1. Observation in the dynamics of the rate (

scholarly journals Simultaneous bilateral spontaneous pneumomediastinum and pneumothorax in a cannabis user

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Sevilay Vural ◽  
Ahmet Tuğrul Zeytin ◽  
Şeyhmus Kaya ◽  
Barış Öztürk
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Emphysema ◽  
Spontaneous Pneumothorax ◽  
Illegal Drug ◽  
Cannabis User ◽  
Western World ◽  
Chronic Obstructive ◽  
Medical Applications ◽  
Obstructive Pulmonary Disease ◽  
Lung Injuries

Cannabis – the most commonly used illegal drug – also has some medical applications. Cannabis is being legalised more and more in the Western world, however it is not a safe substance as many people think. It can cause detrimental acute and chronic lung injuries such as bullous lung disease, chronic bronchitis, chronic obstructive pulmonary disease, pneumothorax, pneumomediastinum, pulmonary emphysema. A clear mechanism for acute pulmonary pathologies has not been established, but pneumothorax and/or pneumomediastinum can be considered as a typical presentation in cannabis users. We present a cannabis user case with simultaneous pneumomediastinum and bilateral spontaneous pneumothorax.

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