Chest wall collapse

Introduction Chest wall collapse: extrapleural thoracoplasty is performed in the subperiosteal resection group ribs, so that the local chest wall collapses, in order to reduce the thoracic cavity of the site 6 to 8 weeks after surgery, the ribs from the periosteum will keep the local chest wall collapse, so that the chest cavity will shrink forever. Thoracic angioplasty is commonly used in chronic empyema. Acute empyema treatment is not timely or improper treatment, residual foreign body in the thoracic cavity, the primary disease causing empyema can not be cured or specific infection can lead to chest wall collapse. Because the disease is a serious wasting disease, it should be treated promptly and ensure nutrient supply.

Cause

(1) The treatment of acute empyema is not timely or inappropriate

During the acute empyema, the selection of antibiotics is not appropriate, or the dosage is not adjusted in time and the sensitive antibiotics are replaced during the treatment. The formation of pus is still more. If the position of the drainage tube is high or low, the depth is not suitable and the diameter is too thin. Or the drainage tube is distorted and blocked, and the drainage is not smooth, and all forms chronic empyema.

(2) Residual foreign bodies in the thoracic cavity

If there is a foreign body, such as metal fragments, bone fragments, broken clothes, etc., remaining in the chest cavity after trauma, or foreign matter remains after surgery, the empyema is difficult to heal, even if the circulation is smooth, the pathogen can not be removed due to the residual foreign matter. The source cannot be cured.

(3) The primary disease causing empyema cannot be cured

If empyema is secondary to lung abscess, bronchospasm, esophageal fistula, liver abscess, underarm abscess, spinal osteomyelitis and other diseases, before the primary lesion is not cured, empyema is also difficult to cure, forming a chronic empyema.

(4) Specific infection

Tuberculous infection, fungal infection, and amoebic empyema are all likely to form chronic empyema.

an examination

Related inspection

Chest MRI

X-ray: the pleural thickening of the affected side, the narrow intercostal space, and the increased density of the large pieces of the hair-like shift shadow. The mediastinum is displaced to the affected side and the diaphragm is raised. High voltage or body slices can show hypertrophic pleural, abscess and lung tissue. If there is a liquid level, it indicates that there is a lung leak, or there is still bronchopleural palsy. Combined with the positive lateral chest radiograph, the size and location of the abscess can be determined. When there is a liquid level, the horizontal position of the lateral position can be used to display the position of the bottom of the abscess.

CT examination: It can further clarify whether the lung tissue has lesions, such as tuberculosis, bronchiectasis, cysts or abscesses, which is of great help to the development of surgical plans. If there is a lung lesion, it is often necessary to perform thoracic stripping plus lobectomy or even pneumonectomy, or thoracoplasty.

B-mode ultrasonography: In the liquid darkness of pleural effusion, because there are many cellular components in the liquid, they often accumulate with each other to form flocs. Therefore, the sound image shows small and uneven, uneven parts. Echo, and a slight float. If the patient moves quickly, the liquid celestial echo rises and even rolls up and down, which is easy to identify.

Differential diagnosis

To identify with a variety of chest deformities such as funnel chest, chicken breasts, etc., rare sternal fissures, and mainly due to trauma or surgery caused by chest deformities.

The funnel chest is recessed downwards in the chest, and the chicken breast is instead convex in the middle of the chest.

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