Pneumothorax

Pneumothorax Defintion :- Presence of air inside the pleural space due to defect in the parietal or visceral pleura

Pathology of pneumothorax

Causes of pneumothorax 1- Spontaneous Commenst type. Young adults Thin and tall who do not have lung disease. Males are affected 4 times than females. Usually at the lung apex . May be due to rupture of congenital pleural bleb. Note :- Pleural bleb :- A small gas space inside the visceral pleura.

Causes of pneumothorax 2- Injury A- Through a chest wall e.g stab wound. B- Road traffic accident . 3- Lung diseases Uncommon complication of some lung diseases such as asthma , emphysema and pneumonia.

Clinical pictures 1- Chest pain 2- Shortness of breath 3- Fainting 4- Rarely cardiac arrest in severe cases ("tension pneumothorax").

Types of pneumothorax 1- Simple 2- Tension

Pneumothorax X-ray views in cases of pneumothorax:- PA inspiratory film +/- PA expiratory film +/ - Lateral decubitus film while patient lying on his normal side

Radiographic appearance 1- Simple pneumothorax Translucent area deprived from lung markings Thin , white , sharp line represents visceral pleura +/- lung collapse

Pneumothorax No vascular markings on right No shift of mediastinum to left Atelectatic right lung Small fluid level near costophrenic angle: (Hydro pneumothorax )  

Radiographic appearance 2- Tension pneumothorax Translucent area deprived from lung markings Thin , white , sharp line represents visceral pleura +/- lung collapse Shift of the mediastinal structure away from the diseased side

Pneumothorax No vascular markings on right Shift of mediastinum to left Atelectatic right lung

Tension Pneumothorax No vascular markings on right Shift of mediastinum to left Atelectatic right lung  

Pneumothorax Air in pleural cavity: no vascular markings Increased density of atelectatic lung: abnormal lung Larger right hemithorax Other findings include: Calcified diaphragmatic pleural plaque

Hydropneumothorax Definition : Causes :- Radiographic picture Presence of air and fluid in the pleural space . Causes :- Trauma Surgery Radiographic picture Air fluid level in the hemithorax

Hydropneumothorax Air in pleural cavity Lung margin visible Bilateral fluid level Note:- Any time you see a horizontal fluid level, it means that there is air and fluid in the pleural space

hydropneumothorax

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