Orax the pyopneum

Pyopneumothorax

Pyopneumothorax is an accumulation of pus and air in the pleural cavity with varying degrees of lung collapse. The disease most often has meta- and parapneumonic origin and occurs as a result of rupture of a lung abscess with the formation of a bronchopleural fistula. Possible traumatic genesis.

Pyopneumothorax is always based on an infectious origin (staphylo- and streptococcal destruction of the lungs, Pseudomonas aeruginosa, anaerobes, and less commonly pneumococci).

There are 3 clinical forms:

1. Acute, violently emerging: a picture of cardiac collapse, a suddenly appearing box sound during percussion over the former dullness, progressive pneumothorax (sometimes tense); The clinical picture of pseudoabdominal syndrome cannot be excluded.

2. Mild form: breakthrough of the abscess into a closed, encysted space. Moderate pain in the side. Inversion of physical signs, deterioration of the patient’s condition with one or another form of destruction of lung tissue (even relatively smooth pneumonia) always serve as a reason to search for pneumothorax.

3. Erased form - the moment of breakthrough into the pleural cavity is difficult to detect. The nuances are important: dynamic monitoring of the patient’s condition and regular x-ray monitoring.

Treatment is carried out in a surgical hospital. In case of acute pyonneumothorax, urgent drainage of the pleural cavity is indicated, more often in the third - fourth intercostal space along the midclavicular line in order to resolve tension pneumothorax, and only then - adequate drainage for evacuation of pus.

The prognosis of the disease is serious.