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PNEUMOTHORAX Xie Can Mao 1st Affiliated Hospital of Sun Yat-sen Universty
Introduction ,[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object],[object Object]
Contents ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is pneumothorax ,[object Object],[object Object],[object Object],[object Object]
Pneumothorax
Classification of pneumothorax ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinical typing of pneumothorax
Pathogenesis and mechanisms ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],Pathogenesis and mechanisms
Pathogenesis and mechanisms ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pathophysiology
[object Object],[object Object],[object Object],Pathophysiology Shows a similar cystic space, completely surrounded by pl pleura
[object Object],[object Object],Pathophysiology Lung parenchyma Surrounded by fibrous tissue
Blebs Male , aged 22 Admission for“ explode dyspnea, left chest pain for 2 weeks ” . Historic left pneumotorax. 镜下见:左上叶表面见数个直径 0.5 ~ 3cm 肺大 疱, 部分随呼吸活动膨大缩小 。
Bullae
[object Object],[object Object],[object Object],Pathophysiology
[object Object],[object Object],[object Object],[object Object],Pathophysiology
Clinical typing of pneumothorax closed communicated tension Rupture   small  large  valve-like sealed  open  in not out Pressure   P or N  atmosphere  high After  Aspiration   N  atmosphere  high again
Clinical manifestation  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinical manifestation
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinical manifestation
Tension pneumothorax
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinical manifestation
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinical manifestation
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinical manifestation
Clinical stability ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Evaluate the severity and make decision for treatment
Imaging- Plane chest X-ray film  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Plane chest X-ray film ,[object Object],[object Object]
Plane chest X-ray film ,[object Object],[object Object]
Plane chest X-ray film ,[object Object],[object Object]
Plane chest X-ray film ,[object Object],[object Object],[object Object],[object Object],[object Object]
Estimation of pneumothorax volume ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object], 100 Hemithorax (HT) Lung (L)
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Estimation of pneumothorax volume
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Plane chest X-ray film
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Plane chest X-ray film
CT scanning ,[object Object],[object Object],[object Object]
CT scanning bullae pneumothorax
CT scanning bullae pneumothorax pneumothorax
CT scanning pneumothorax
CT scanning Small pneumothorax Subcutaneous emphysema
Differentiation  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Treatment
Observation - PSP ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Observation - SSP
[object Object],[object Object],[object Object],Observation -  PSP or SSP
[object Object],[object Object],[object Object],Observation -  PSP or SSP
[object Object],[object Object],Observation -  PSP or SSP
Simple aspiration ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Repeated and catheter aspiration
Catheter aspiration ,[object Object]
Intercostal tube drainage Fix the catheter and cover with gauze Making a small incision Using a forceps to extend the hole Inserting a catheter into pleural cavity
Intercostal tube drainage
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Intercostal tube drainage
[object Object],[object Object],[object Object],Intercostal tube drainage
[object Object],[object Object],Intercostal tube drainage
Guidewire tube thoracostomy  ,[object Object]
[object Object],Guidewire tube thoracostomy
[object Object],Guidewire tube thoracostomy
[object Object],Guidewire tube thoracostomy
[object Object],Guidewire tube thoracostomy
[object Object],Guidewire tube thoracostomy
Trocar tube thoracostomy  ,[object Object],[object Object]
Trocar tube thoracostomy  ,[object Object]
Operative tube thoracostomy ,[object Object],Is it brutal? No!
[object Object],Operative tube thoracostomy
Drainage system
One bottle system ,[object Object],[object Object],[object Object],[object Object]
One bottle system
[object Object],[object Object],[object Object],[object Object],[object Object],One bottle system
Three bottle system ,[object Object],[object Object],[object Object],[object Object]
[object Object],Three bottle system
Observation of drainage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of intercostal tube drainage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chemical pleurodesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chemical pleurodesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Chemical pleurodesis
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Chemical pleurodesis
Surgical treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of pneumothorax  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Complications
Complications
Complications
[object Object],[object Object],[object Object],[object Object],Complications
Complications  Pneumomediastinum  Pneumocardium Pneumoperitoneum Surgical emphysema
Complications  Subcutaneous  emphysema
complications ,[object Object],[object Object],[object Object],[object Object]
Case study ,[object Object],[object Object],[object Object],[object Object],[object Object]
Questions  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Questions  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Questions  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
3 pneumothorax

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