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Pneumothorax

Pneumothorax is the entry of air into space (virtual in the healthy) interpleural:
between the visceral and parietal pleura.

It results in a pulmonary collapse of greater or lesser magnitude, with its


corresponding repercussion in the respiratory and hemodynamic mechanics of
the patient, where the origin can be external (perforation in the rib cage) or
internal (perforation in a lung). Of its pain, location and intensity, may be
confused with angina pectoris or myocardial infarction.

Although proper hospital care does not pose a great risk to the person's life,
the diagnosis must be rapid and his attention almost immediate, since in
addition to pulmonary collapse and due to loss of oxygen, the formation of a
tension pneumothorax (Where air enters the interpleural space but does not
come out) can be fatal in a very short time, as it compresses the other lung
and heart.

Clinical Chart

It usually presents the following symptoms and clinical signs:

Sudden onset of dyspnea, variable intensity in relation to the size of


pneumothorax..
Rapid and superficial respiratory movements (tachypnea and hypopnea)
Ag Acute chest pain, which has a sharp character that increases its
intensity with inspiration and cough, usually in the axillary region
spreading to the region of the shoulder and / or back (pain in the side
stitch).
Dry, persistent cough, which is markedly exacerbated by pain.
Other: cyanosis, tachycardia.

In the physical examination we can verify:

Inspection: in severe pneumothorax, immobility of the affected


hemithorax, and in rare cases, its vault.
Palpation: decrease or abolition of vocal vibrations in the affected area,
with excursion of the lung bases decreased.
Percussion: hypersority or tympanism.Ausculation: vesicular murmur
abolished or diminished (auscultatory silence), rarely amphoric murmur.
Treatment

The tension pneumothorax is a serious emergency, because the air enters


but by valvular action does not leave.
Spontaneous pneumothorax requires cutaneous puncture with drainage
through the pleura (because air is reabsorbed by the intercostal tube of the
affected lung) that should be removed when air leakage ceases. If it was
mild it is sufficient to rest after stopping it, but the risk of a new
pneumothorax recurring in the year following the first year is quite high, in
which case surgical intervention may be appropriate for sealing the pleura
and resection of The affected areas that present a pathological condition
such as bullous disease.

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