Pneumothorax

FLAIL CHEST

  • It occurs when two or more adjacent ribs are segmentally fractured in two or more places.
  • There is hypoventilation (carbon dioxide retention and respiratory failure)

Treatment :-

  • Pulmonary toilet : exercises and procedures that help to clear your airways of mucus and other secretions.
  • Tube thoracostomy : insertion of a thin plastic tube into the pleural space (the area between the chest wall and lungs.)
    • The tube is attached to a suction device to remove excess fluid or air.

PECTUS EXCAVATUM (FUNNEL CHEST OR SAUCER CHEST)

  • The body of sternum, usually the lower end is curved backwards.
  • The heart is displaced to the left and may be compresssed between the sternum and the vertebral column.

PECTUS CARINATUM (PIGEON CHEST)

  • This is a malformation of the chest characterized by a protrusion of the sternum and ribs.
  • It is usually caused by rickets and severe bronchial asthma in childhood.

PNEUMOTHORAX

  • An abnormal collection of air in the pleural space between the lung and the pleura.

Classification :-

  1. Simple pneumothorax
  2. Open pneumothorax
  3. Tension pneumothorax

Simple pneumothorax :-

  • It resolve without treatment and requires only monitoring.

Open pneumothorax :-

  • Generally occurs due to penetrating thoracic trauma when the chest wall wound remains patent.
  • Treatment : By closure of the wound, intercostal tube drainage (ICD) and surgery.

Tension pneumothorax :-

  • It is an immediately life threatening injury that results when gas builds up under pressure within the pleural space after blunt or penetrating thoracic trauma.
  • In this condition, respiratory gases may escape from the injured lung during each respiratory cycle or may be entrained into the pleural cavity from the outside during inspiration.

Treatment :-
Tension pneumothorax should be treated by prompt needle thoracostomy.

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