Pneumothorax
Air leak in lungs
What is a pneumothorax?
It deflates the lung like a balloon due to the accumulation of air between the two membranes surrounding the lungs for various reasons.
In other words, air leakage occurs in the lung, and the air that should be in the lung settles between the thorax and the lung. Thus, the situation in which the lungs cannot perform their breathing function occurs.
Part or all of the lung may be deflated. According to these possibilities, it cannot fulfill its task wholly or partially, so shortness of breath and shortness of breath occur.
Chest pain may also be felt due to the tension of the pleura while deflating.
What causes pneumothorax?
There are many different reasons:
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SMOKING (and all tobacco products: hookahs, e-cigarettes (electronic cigarettes), rolling tobacco, marijuana, pipes, and many more): It disrupts the spongy lung structure. It forms air cysts. Pneumothorax occurs due to the bursting of these air cysts.
20 TIMES in smokers compared to non-smokers; The risk of developing pneumothorax increases ten times more in smokers than in non-smokers!
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Lung tissue may rupture, and pneumothorax may develop due to intrathoracic pressure and tension in tall thin men. If he also smokes, this risk increases even more.
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If there is an existing lung disease, it may develop due to the destruction of the lung tissue developed by this disease:
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COPD (chronic obstructive pulmonary disease)
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Lung infection
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Lung cancer
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interstitial lung disease
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Asthma
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Like cystic fibrosis.
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Trauma
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Penetrating tool injury
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Blunt trauma such as falling, impact
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Explosion
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Pneumothorax may develop as a complication after some medical interventions.
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Transthoracic needle aspiration biopsy
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Vascular catheterizations etc.
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*(Complication: It is a side effect of a disease or treatment.)
How is pneumothorax diagnosed?
The doctor takes the patient's complaints and past medical history, and the diagnosis is made with the help of a respiratory system examination, chest X-ray, or, if necessary, other imaging systems.
How is pneumothorax treated?
It varies depending on the patient's clinic, disease history, comorbidities, and the amount of pneumothorax seen in the imaging systems. After evaluating all these, your thoracic surgeon will make the right decision. Treatment scale of pneumothorax; It includes a wide range of options, from medical treatment such as flat-lying oxygen inhalation therapy, and respiratory physiotherapy, to inserting a thorax (chest) drain or pneumothorax surgery.
What is a thorax (chest) drain (tube)?
It is an underwater drainage system that empties the air that should not be between the rib cage and the lungs and creates negative pressure in this area, allowing the deflated lung to inflate again.
It is the insertion of a silicone drain between two ribs to the thorax (right or left) with pneumothorax under sterile conditions under local anesthesia. The end of this drain is connected to an underwater drainage system bottle. Thus, the air accumulated inside goes out, but the outside air cannot enter the chest again. As a result, the lungs begin to inflate again, thanks to the negative pressure created between the rib cage and the lungs.
The healing process and time vary depending on the disease history and condition and the quality of the lung. In this process, the patient's and relatives' adaptation to the disease and the complete respiratory physiotherapy taught to the patient/homework will contribute to the treatment positively.
The most common complaint of the patient in this process is the pain that may occur at the drain entrance, chest, and back. Usually, this pain is mechanical pain of the drain. Painkillers may not wholly relieve this pain, but the pain may disappear almost entirely after removing the drain. For the drain to come out, the lung must inflate in a way that does not go out. This depends on the patient's compliance with respiratory physiotherapy, the existing disease, and lung quality.
What is pneumothorax surgery?
According to the patient's clinical condition, the necessity of a surgical operation is decided in case of recurrent pneumothorax or "prolonged" (as of the elapsed time) air leak despite the insertion of a thoracic drain.
Surgical operation principles:
It is done under general anesthesia.
Generally, closed operation is preferred. Closed operation means entering the rib cage between the two ribs with one or a few small incisions (1-2 cm). It is to view the lung and surrounding tissues inside with the help of a video camera, repair the lung tissue that causes air leakage using closed-system surgical instruments, remove the damaged tissue, and perform other necessary procedures.
An operation that started may turn into an open (thoracotomy) function due to a necessary situation during the operation.
Or, if it is deemed necessary in the first place, an open operation can be decided.
At the end of the operation, one (or rarely two) thoracic drains are placed in the thorax.
How will my thoracic drain come out?
Pulling the thoracic drain is more straightforward and painless than inserting it. It is usually performed at the patient's bedside and removed by the doctor. If the patient carefully follows some instructions that the doctor will inform before taking it, it will be completed in a few minutes without any problems.
How can I avoid getting a pneumothorax?
The preventable risk factor is SMOKING (and all tobacco products). If you are a smoker, you reduce your risk of spontaneous pneumothorax by quitting smoking.
Suppose you are an individual with lung disease and still use tobacco products. In that case, it means that you both increase your risk of pneumothorax and complicate your recovery process in case of pneumothorax that may develop due to your disease.
Remember, the risk of contracting the disease, the response to the condition, and the answer to the treatment of a smoker will be more problematic and slow compared to a non-smoker body.
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