Definition and causes
Between the lungs and chest wall are lungesækken (pleural), which on each page containing the lung. Lungesækken consists of 2 prevent, 1 which face the lungs, and 1 overlooking the chest wall. These prevent forming a spalterum among themselves (pleurahulen). Under normal circumstances, pleurahulen pressure completely together, inter alia, due to a thin liquid layers that keep the 2 preclude together. If the air into the pleurahulen (as the lung pressed together), we speak of pnemothorax.
Pneumothorax can either happen spontaneously, that is. by itself, or by an external impact (traumatic), as often happens in relations with accidents.
We share spontaneous pneumothorax up in aprimaryandsecondaryshape. People who have a primary spontaneous pneumothorax, has no prior lung diseases and are generally healthy. At the secondary spontaneous pneumothorax, the person is already a known chronic lungelidelse like. emphysema , COPD (smokers) or cystic fibrosis .
By spontaneous pneumothorax happens a bristning in small bladders, which sits on the surface of the lung, which filter air out of pleurahulen, and a compression of the lung. Normally, this bristning close spontaneously, and the lung will be right out again. There may, however, formed a ventilfunktion in utætheden, so that can only air out of pleurahulen, but not back into the lung. This raises the statetrykpneumothoraxWhere more and more air trapped in pleurahulen. This is a serious condition, as the rising air can affect the large blood vessels and the heart, which is potentially life-threatening.
A primary spontaneous pneumothorax affects people in the 20-40 years of age, and viewed 9 times more frequently in men than women.
The secondary spontaneous pneumothorax seen in people over 60 years, with a known lung disease.
Both types are frequent occurrences modes.
Smoking is a major risk factor for the development of spontaneous pneumothorax (emphysema and COPD , As available to secondary spontaneous pneumothorax, almost always caused by smoking).
In the case of accidents, which cause damage to the chest, the risk of pneumothorax great. Due. the high energy, which arise, for example. car accidents, falls from a horse and the like, there may be damage to the ribs, blood vessels and lung tissue. A broken rib can easily "prick" a lung and cause pneumothorax. Therefore, we must quickly get assistance if the accident is experiencing the following symptoms after an accident. The injuries in the chest and the back is the risk of pneumothorax great.
Symptoms of pneumothorax
The main symptoms are:
- Stikkende pain in the chest on the sick side.
- Shortness of breath.
The extent of åndenøden and the pain is very dependent on lungernes state. This means that a young person with healthy lungs may have few symptoms of a large pneumothorax. On the other hand, an older person already sick lungs have severe symptoms of a small pneumothorax. In the worst cases, iltforsyningen be so little to develop blue lips as a sign of too little oxygen in the body.
Precautions and diagnosis
Is there already a known chronic lungelidelse, be sure to a deterioration in a similar breathing or sudden pain in the chest. Young men who feel the above symptoms, should also be aware that a doctor.
The doctor may in severe cases diagnose pneumothorax by stetoskopi. It is always an X-ray of the chest, if you suspect a pneumothorax. This will display a sky between the lung and chest wall and a collapsed lung in varying degrees.
Traumatisk pneumothorax can be referred developed after stikuheld or blow on the chest wall. Mistænkes pneumothorax after an accident takes very quickly a røngenbillede or CT scan to confirm the diagnosis.
Consideration of pneumothorax
In the light where there is a less luftbræmme between the lung and chest, will observe the patient, and pneumothoraxen will disappear in the course of typically 14 days. If there is a greater pneumothorax, Monday brings a drain (a plastikslange) between 4. and 5. ribs. This sinks sucks air and fluid out of pleurahulen by which the lung unfolds out again.
In the event that the lung is not folded out after 2-3 days, will carry out an operation, which removes the bladders, which is why lækagen. In addition, you will scrape the outer skin of, and sometimes will remove the entire lungesækken to prevent recurrent pneumothorax.
Elderly people with chronic lungsygdomme like. COPD (smokers) tolerate bad operation, which is typically choose to treat these patients with sinks. This can be combined with the injection of a substance slimhindeirriterende (talc or tetracycline) that gets 2 lungehinder to grow together, so there is no longer collected air between them.
In connection with the accident Monday brings a lungedræn by the slightest suspicion of traumatic pneumothorax, even if you have not taken røngtenbillede or CT scan to confirm the condition. If the injured must be transported by ambulance or operated under anaesthetic, takes also always lungedræn.
Select and complications
The problem is that pneumothorax often are recurrent, so that the risk of another pneumothorax after drænbehandling of a primary spontaneous pneumothorax is 40%. If the patient has been treated more than 2 times with sinks, the risk of getting a new pneumothorax almost 100%. Therefore, these patients to undergo an operation, since the risk of a recurrent pneumothorax thus lowered to 1%.
By drænanlæggele there is a risk of infection, so treating with antibiotics.
There are traumatic pneumothorax risk of bleeding of the arteries, which is around the lungs and chest. In the case of traumatic pneumothorax as a result of stikuheld, there is great risk that the heart may be damaged. There may also be bleeding in lungehulen. This is called hæmothorax.
Have we had a pneumothorax in the one hand, the risk of developing one of the other 5%.