Traumatic pneumothorax can occur as a result of both penetrating and non-penetrating injuries of the chest.
Mechanism
When penetrating wounds of the chest images mechanism Bani pneumothorax obvious, since as a result the air enters the injured pleural cavity, directly through the chest wall. In addition, the visceral pleura is often damaged, which allows air to enter the pleural cavity from the alveoli. Nonpenetrating wound may be accompanied by a fracture or displacement of the ribs, wherein the damaged hanging tseralnaya pleura and develops pneumothorax. However, the pain shinstva patients with pneumothorax, arising as a result of penetrating wounds of the chest, rib fracture is not observed . It is believed that in such pain pneumothorax GOVERNMENTAL is, the result m the following mechanism of action . With a sharp compression of the chest alveolar giving Lenie can expand in that there is a break al Veolia. Air as a result of this goes into the interstitial space, cutting it in a direction towards the visceral plevu D or mediastinum, causing the formation of emphysema among walls; gap visceral pleural or mediastinal ve children to the formation of pneumothorax.
Treatment
Treatment of patients with traumatic pneumothorax should be carried out by drainage using the method of thoracostomy . In case gemopnevmotoraksa one drainage tube is introduced into the upper part of the hemithorax to allow air to exit, and the other – the lower the blood removal (see chapter. 20). When in trauma Český pneumothorax after 72 h of light usually occurs unfolding and termination Incoming air.
In a patient with traumatic pneumothorax, two rare types of injury should be kept in mind, both are indications for emergency thoracic surgery: rupture of the trachea or one of the main bronchi and traumatic perforation of the esophagus. Bronchus rupture most frequently observed in patients with prior to him or lateral fracture of the first three ribs . Patients with traumatic pneumothorax should produce fibrobronhoskopicheskoe study to identify bronchus gap that can appear hemoptysis, extensive pneumonia motoraksom continuing with air entering into stubble -sectoral cavity (arising due to drainage method torakostomii ) or be the result of a fracture of the first three D ber or one of them . Traumatic perforation of pi schevoda usually causes the development hydropneumothorax . Therefore th, if a patient with traumatic pneumothorax image etsya pleural effusion should be suspected perforation pi schevoda. Reliable method of research, serving to you esophageal perforation phenomenon is the definition contains Nia amylase in pleural fluid . With an elevated amylase content, a contrast study of the esophagus is necessary.