Barrel chest

Introduction When the ratio of the left and right diameter of the thorax to the anteroposterior diameter is 1:1, it is like a "barrel shape", so it is called "barrel chest". Also known as "emphysema chest." barrel chest" is generally caused by excessive gas content in the lungs, such as emphysema, acute asthma attacks and long-term heavy smoking can lead to such performance, individual normal people can sometimes A "barrel chest" appears. The anteroposterior diameter of the thorax is increased, the thoracic cage is rounded, the anteroposterior diameter is increased, or is approximately equal to the left and right diameters. The anterior part of the rib arch is raised, the rib is horizontal, the intercostal space is widened, and the lower sternal angle is obtuse. The chest echo of percussion increased, the heart sounds narrowed or disappeared, and the liver dullness decreased. Breathing sounds and voices are weakened, exhalation is prolonged, and sometimes the lungs and the bottom can smell dry and wet rales. The heart sounds low.

Cause

Barrel chests can be caused by chest or systemic diseases, but also due to congenital causes. More common in emphysema caused by bronchial asthma, chronic bronchitis.

Thoracic disorders, often caused by acute inflammation or tumors of the ribs, costal cartilage, spine, and chest wall, such as rib fractures, costal cartilage, benign and malignant tumors of the chest wall, and thoracic trauma.

Pleural disorders, pleural effusion, pneumothorax can make the thoracic (infected side) full, pleural mesothelioma makes the thorax abnormally full.

Respiratory diseases, extensive fibrosis of the lungs, emphysema, bronchial asthma, etc. can cause malformation or bulging of the thoracic whole or local. Lung cancer may be associated with thoracic deformity due to alveolar stenosis, emphysema or metastasis to the pleura and ribs.

Circulatory disorders, heart enlargement, pericardial effusion, aortic aneurysm, etc. can cause local thoracic abnormalities.

Other causes, old age and obese body shape. Long-term large number of smokers, etc.

an examination

Related inspection

Chest B-cardiopulmonary exercise test (CPET)

X-ray examination showed an increase in lung transparency. But in the early days this X-ray sign was not sensitive enough. In severe emphysema, the thorax is full, the ribs are flattened, and the intercostal space is widened. Lateral thoracic anterior and posterior diameters were enlarged and the posterior sternal space was too wide. The diaphragm is moved down and the sputum becomes flat. The transparency of both lungs is increased, and the blood vessels in the lung field are fine and sparse. The heart shadow is vertically narrow. Under the fluoroscopy, the thoracic and diaphragmatic activities are weakened. There is also an increase in lung texture, the increase in lung transparency is not obvious, the pulmonary artery in the hilar is widened, and the heart is often enlarged.

Pulmonary function tests, obstructive emphysema caused by barrel pleural effusion mainly obstructive ventilatory dysfunction, such as FEV, maximum ventilation decreased, residual gas volume increased, residual gas volume as a percentage of total lung volume increased.

Those with abnormal thoracic diseases caused by respiratory diseases, sputum bacteria and exfoliated cells, pleural fluid examination, and biopsy may have corresponding changes.

Differential diagnosis

It should be noted that the identification is physiological or pathological barrel chest.

The anteroposterior diameter of the thorax is increased, the thoracic cage is rounded, the anteroposterior diameter is increased, or is approximately equal to the left and right diameters. The anterior part of the rib arch is raised, the rib is horizontal, the intercostal space is widened, and the lower sternal angle is obtuse. The chest echo of percussion increased, the heart sounds narrowed or disappeared, and the liver dullness decreased. Breathing sounds and voices are weakened, exhalation is prolonged, and sometimes the lungs and the bottom can smell dry and wet rales. The heart sounds low.

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