Pleural adhesions

Introduction The so-called pleural adhesion is the adhesion of the two layers of the pleura. This lesion is caused by tuberculosis, pleurisy, and chest injury. Limitations often occur at the corners of the ribs, causing the squat movement to weaken there. The pleura can also have a wide range of layer thickening and adhesion, which not only causes the rib gap to shrink, but also the mediastinum shifts to the affected side. The spine is convex to the opposite side, the diaphragm is raised, and the hilar is lifted up. The affected side is displaced, and the pleural adhesion is in addition to the membranous shape. There is also a cord-like type, which mainly occurs between the chest wall and a lung surface.

Cause

Causes of pleural adhesions

The reason is that there is often oozing fluid in the pleural cavity of this type of injured patient. Once the fibrin in the effusion is deposited on the pleura, the pleural thickening can occur. If fibrin is stagnation, the opposite two layers The pleura gradually sticks, or there is granulation tissue hyperplasia in the pleural cavity, which can also lead to thickening of the pleura and adhesions. The clinical symptoms vary, but there are symptoms such as chest pain or difficulty breathing.

an examination

Related inspection

Chest CT scan of chest flat film

The pleural thickening and adhesions are limited and extensive. Adhesion of a wide range of visceral layers can affect the respiratory function of the lungs. Extensive adhesion of the wall layer can result in narrowing of the intercostal space and shrinking of the thorax. Limitations often occur at the corners of the ribs, causing the squat movement to weaken there. The pleura can also have a wide range of layer thickening and adhesion, which not only causes the rib gap to shrink, but also the mediastinum shifts to the affected side. The spine is convex to the opposite side, the diaphragm is raised, and the hilar is lifted up. The affected side is displaced, and the pleural adhesion is in addition to the membranous shape. There is also a cord-like type, which mainly occurs between the chest wall and a lung surface. This adhesion is caused by the upper lesion of the lungs.

Patients seen in the clinic often have both pleural thickening and pleural adhesions. The clinical symptoms vary, but there are common symptoms such as chest pain or difficulty breathing.

Differential diagnosis

Differential diagnosis of pleural adhesions:

1, pleural thickening adhesion: tuberculosis, pleurisy and chest injury patients often have effusion in the pleural cavity, once the fibrin in the effusion is deposited on the pleura, can lead to pleural thickening, if fibrin Sinking, the opposite two layers of pleura gradually stick, or there is granulation tissue hyperplasia in the pleural cavity, which can also lead to thickening of the pleura and adhesion.

2, pleural thickening: pleural hypertrophy is first caused by pleurisy. Some are more than 2 cm, composed of fibrous connective tissue, grayish white, the surface is granulation tissue, there are a lot of necrotic tissue and empyema in the abscess and there are two kinds of pleurisy. One is dry pleurisy (no pleural effusion) ), the other is exudative pleurisy (with pleural effusion). The production of pleural hypertrophy is mainly due to the second type of pleurisy. Because the pleural effusion was not detected and pumped in time, the pleural effusion stayed in the pleural cavity for a long time. The pleural effusion stimulated the pleura and the pleural effusion with fibrin attached to the chest wall, which increased the pleural hyperplasia. Therefore, patients suffering from pleural effusion should go to the hospital for treatment in time, otherwise it will easily produce pleural hypertrophy.

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