What causes secondary pneumothorax? Are there any complications of spontaneous pneumothorax?

There are many secondary pneumothoraxes, the most common ones are viral pneumonia or bacterial pneumonia and fungal pneumonia can cause pneumothorax, and some pneumothorax patients are caused by chronic bronchitis, or acute bronchitis, and some patients are due to pneumoconiosis caused by pneumothorax, and some patients are caused by asthma disease, or obstructive pulmonary disease can also cause pneumothorax, as well as pulmonary interstitial fibrosis, honeycomb lung, bronchopulmonary cancer, can cause pneumothorax. In other patients, pneumothorax can be caused by lung abscess or pleurisy, as well as tuberculous cavitation of lung abscess.

What is secondary pneumothorax**? Understanding pneumothorax** is very helpful in understanding this disease, and the medical education network shares as follows:

How is a pneumothorax diagnosed?

The mechanism of this is the formation of bullae or direct injury to the pleura on the basis of other lung diseases. It is often based on chronic obstructive pulmonary emphysema or post-inflammatory fibrosis (such as silicosis, chronic tuberculosis, diffuse pulmonary interstitial fibrosis, cystic pulmonary fibrosis, etc.), bronchiole inflammation is narrowed and twisted, and the valve mechanism is produced to form pulmonary bullae. Enlarged emphysema bubble is degenerative due to nutritional and circulatory disorders.

Chronic obstructive pulmonary disease (COPD) is the most common form of secondary pneumothorax**, with approximately 57% of secondary pneumothorax due to COPD. As the severity of COPD increases, so does the risk of developing pneumothorax.

Spontaneous pneumothorax is a rupture of lung tissue and visceral pleura due to lung disease, or the rupture of fine emphysema bubbles near the surface of the lungs, allowing air from the lungs and bronchial tubes to escape into the pleural space. It is more common in young men or those with chronic bronchia, emphysema, and tuberculosis. This disease is one of the pulmonary emergencies, and severe cases can be life-threatening, and timely treatment can be done.

1. The incidence of pleural effusion is 30% to 40%, which mostly occurs 3 to 5 days after the onset of pneumothorax, and the amount is usually not much, and the effusion not only aggravates lung collapse, but also tends to develop pneumothorax for patients with open pneumothorax.

2. Pneumothorax secondary to Staphylococcus aureus, anaerobic bacteria or gram-negative bacilli causing purulent pneumonia, or lung abscess, or caseating pneumonia pneumothorax is easy to be combined with pneumothorax.

3. Hemopneumothorax caused by tearing of blood vessels in the pleural adhesions. The severity of the disease is related to the size of the torn blood vessel. Small hemorrhages stop automatically with constriction of blood vessels and contraction of the endothelium; In addition to chest pain, chest tightness, and shortness of breath, there are signs of hemorrhagic shock such as dizziness, palpitation, paleness, cold dampness, and blood pressure drop.

4. Chronic pneumothorax: Some elderly patients with pneumothorax cannot close the pleural dehiscence with compression due to the underlying lesions; bronchopleural fistula forms that are difficult to heal; Bronchial stenosis or occlusion that prevents the lungs from re-inflating; Hypertrophy and myolysis of the visceral pleura prevents the lungs from fully re-expanding, resulting in a pneumothorax that lasts for more than 3 months.

5. Mediastinal emphysema is mostly complicated by tension pneumothorax. When the gas volume is low, there may be no obvious symptoms; Circulatory respiratory failure occurs in patients with large and rapid volume, and the condition is extremely dangerous, with cyanosis, jugular venous distension, palpability of the heart, narrowing or loss of dullness of the cardiac voice, often accompanied by subcutaneous emphysema (local swelling, snow grip on palpation, crepitus on auscultation), and chest x-ray showing translucent bands on both sides of the mediastinum bounded by cord shadows.

6. Respiratory failure: This is a very common complication of elderly pneumothorax secondary to COPD.

7. Circulatory failure is mostly complicated by tension pneumothorax.

8. Heart failure is more common in elderly pneumothorax patients with severe heart disease. Heart failure can be induced by hypoxemia, infection, increased oxygen consumption by respiratory exercise, and arrhythmias due to pneumothorax.

It is usually more common in tall, thin young people. It is estimated that the patient also belongs to this category, and the study is of little significance at this time, and the number of studies will decrease as the age and physique gradually improve.

The main complications are pneumothorax, hemopneumothorax, and chronic pneumothorax. In recent years, with the aseptic operation of thoracic surgery and the timely use of antibiotics, pneumothorax complicated by pneumothorax is rare.

1) Hemopneumothorax: Spontaneous pneumothorax causes the blood vessels in the pleural adhesion to be torn. The onset is abrupt, in addition to chest tightness and shortness of breath, chest pain continues to worsen, accompanied by dizziness, paleness, rapid pulse, hypotension, etc. Signs of pleural effusion are abundant in a short period of time, and x-rays show fluid gas levels.

Thoracentesis is whole blood.

2) Chronic pneumothorax refers to the pneumothorax that has not been absorbed for more than 3 months. Factors of incomplete lung expansion are: pleural adhesion traction, which keeps the pleural hiatus open; The hiatus passes through the cyst or lung tissue, forming a bronchopleural fistula; Cellulose and organisation on the surface of the visceral pleura, which restricts lung expansion; Lesions in the bronchial lumen cause complete obstruction, preventing the collapsed lung from re-inflating.

In addition, it can be complicated by fluid pneumothorax and bronchopleural fistula. If left untimely**, death can occur due to acute progressive respiratory and circulatory failure due to lung atrophy and mediastinal compression and displacement.

It refers to the pathophysiological condition caused by the rupture of the visceral pleura and the entry of gas into the pleural cavity in the absence of trauma or human factors. Patients with pleural and lung diseases secondary to COPD, tuberculosis, etc., are called secondary pneumothorax, which is divided into closed (simple) according to pathophysiological changes

There are three categories: openness (traffic) and tension (high pressure).

It is due to lung or pleural lesions, which cause the visceral pleura to rupture, causing air to enter the pleural space and form a pneumothorax.

After the pneumothorax is produced, the pleural cavity is entered.

The increased pressure (normally negative pressure in the pleural cavity) prevents the lungs from expanding, and the lung pressure is directed towards the hilum and even the trachea, heart, etc., which are pushed to the contralateral chest cavity.

1。Traumatic pneumothorax: caused by a stab wound to the chest with a sharp object;

2. Primary pneumothorax: pneumothorax occurs in healthy people without obvious lung lesions, mostly in young adults aged 20-40, and more common in men;

3. Secondary pneumothorax: pneumothorax secondary to various diseases of the lungs, such as chronic bronchitis, emphysema, tuberculosis, lung cancer, etc.

It is also sometimes divided into open pneumothorax and closed pneumothorax.

1.Trauma can be a direct stab to the lungs with a sharp object, or a blunt instrument can lacerate the lungs by acting on the surface of the chest wall and transmitting force.

2.Strenuous exercise can occur in healthy people.

3.People who have a disease of their own lungs.

4.Iatrogenic means medical malpractice.

1.Spontaneous pneumothora: Spontaneous pneumothorax in adolescents is usually caused by rupture of subpleural bullae at the apex of the lungs. 2.

Rupture of bullolar emphysema, due to chronic obstructive pulmonary disease, over-inflats the alveolar units, resulting in destruction of the alveolar wall over time3Pulmonary tuberculosis In the 50s of the 20th century, pulmonary tuberculosis was one of the important factors causing spontaneous pneumothorax.4Other (1) Infection:

Staphylococcal aureus pneumonia.