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  • Pneumothorax, Lung Abscess, Bronchiectasis, Massive Hemoptysis

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    Richard John Paul Samuel
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    A pneumothorax is a collection of air in the pleural cavity causing symptoms like cough, dyspnea and chest pain. It is diagnosed using chest x-rays or CT scans. Treatment involves needle decompression and placement of a chest tube to remove air. A lung abscess is a localized collection of pus in the lung caused by infection, diagnosed on chest imaging and treated with antibiotics or drainage procedures. Massive hemoptysis involving over 600ml of blood in 24 hours is a medical emergency diagnosed by imaging and sometimes treated with embolization to stop bleeding.

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    Pneumothorax, lung abscess, Bronchiectasis, Massive Hemoptysis

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    A pneumothorax is a collection of air in the pleural cavity causing symptoms like cough, dyspnea and chest pain. It is diagnosed using chest x-rays or CT scans. Treatment involves needle decompression and placement of a chest tube to remove air. A lung abscess is a localized collection of pus in the lung caused by infection, diagnosed on chest imaging and treated with antibiotics or drainage procedures. Massive hemoptysis involving over 600ml of blood in 24 hours is a medical emergency diagnosed by imaging and sometimes treated with embolization to stop bleeding.

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    4 views16 pages

    Pneumothorax, Lung Abscess, Bronchiectasis, Massive Hemoptysis

    Uploaded by

    Richard John Paul Samuel
    A pneumothorax is a collection of air in the pleural cavity causing symptoms like cough, dyspnea and chest pain. It is diagnosed using chest x-rays or CT scans. Treatment involves needle decompression and placement of a chest tube to remove air. A lung abscess is a localized collection of pus in the lung caused by infection, diagnosed on chest imaging and treated with antibiotics or drainage procedures. Massive hemoptysis involving over 600ml of blood in 24 hours is a medical emergency diagnosed by imaging and sometimes treated with embolization to stop bleeding.

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    Flag for inappropriate content
    of 16

    VEDIKA SAXENA

    Pneumothorax
    A pneumothorax is a collection of air outside the lung but within the
    pleural cavity
    CLINICAL MANIFESTATIONS
    SYMPTOMS
    • Cough
    • Dyspnea
    • Pleuritic Chest Pain
    • Subpleural Emphysema
    • Tachypnea
    • Tachycardia
    • Low BP
    • Hyperresonance
    • Decreased Tactile Fremitus
    • Decreased or Absent
    Breath Sounds
    DIAGNOSIS

    Chest X- Rays Chest CT


    TREATMENT
    Needle Decompression and Chest Tube Partial (3 sided ) Occlusive Dressing

    Needle
    Decompression

    Thoracostomy Tube

    Open Pneumothorax
    WHY IS THE 4-5 ICS PREFERED OVER THE 2ICS?
    1.Inability to reach the pleura
    2.The site is difficult to find
    Chest wall thickness is less in the 4-5 ICS than 2ICS
    Primary Spontaneous Pneumothorax Secondary Spontaneous Pneumothorax

    Supplemental Oxygen Therapy


    LUNG ABSCESS
    • A localized collection of necrotic tissue and pus within the lung
    parenchyma caused by microbial infiltration

    Other Secondary Causes


    Clinical Features
    • Acute presentation symptoms< 6 months
    • Chronic presentation symptoms > 6 months
    Complications
    Spiking Fever
    Purulent foul smelling sputum
    Pleuritic Chest pain
    Night Sweats
    Weight loss
    DIAGNOSIS
    Chest X ray (initially)
    Chest CT
    Sputum culture, Gram Stain

    Chest X- Ray
    Chest CT
    DIFFERENTIAL DIAGNOSIS

    TUBERCULOSIS- CT SCAN Bronchiogenic Carcinoma CT


    TREATMENT
    Antibiotic Therapy- Clindamycin, Interventional Therapy
    Ampicillin, Vancomycin Criteria-
    • Abscess > 6-8cm – antibiotics ineffective
    Antibiotics chosen against MRSA if • `Significant Hemoptysis
    abscess acquired in the hospital
    Bronchoscopic Drainage
    Treat underlying cause Percutaneous Drainage (via CT)

    Surgical Resection
    Wedge resection, lobectomy,
    pneumonectomy
    BRONCHIECTASIS
    • Irreversible airway
    dilation of medium to
    large sized bronchi
    • Main Cause- Chronic
    Inflammation

    CLINICAL MANIFESTATION
    • Chronic productive cough
    • Dyspnea
    • Hemoptysis
    • Chest pain
    Chest CT

    Chest X- Ray
    TREATMENT
    MASSIVE HEMOPTYSIS
    • expectoration of over 600 mL of blood within a 24-hour period
    • Medical emergency
    • If associated with fever, chills- sign of infection
    • If associated with smoking, weight loss, clubbing- sign of malignancy

    DIAGNOSIS
    Gold standard- CXR
    Chest CT
    Flexible bronchoscopy
    CT Angiography
    TREATMENT

    transcatheter embolization-
    fibrinogen + Thrombin

    15- 40% mortality rates

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