ISSN 2398-2950      

Pneumothorax

ffelis

Introduction

  • Unilateral or bilateral presence of air in pleural space (bilateral much more common due to fragile mediastinum).
  • Cause: trauma, eg hit by car (HBC/RTA); spontaneous, iatrogenic.
  • Signs: dyspnea.
  • Diagnosis: radiography.
  • Treatment: thoracentesis.
  • Prognosis: fair to good.

Pathogenesis

Etiology

  • Trauma, especially hit by a car (HBC/RTA).
  • Penetrating chest wound.
  • Acute heart failure Heart: congestive heart failure.
  • Spontaneous.
  • Pulmonary cysts.
  • Lung abscess.
  • Abscess due to tumor necrosis.
  • Acute necrotizing pneumonia Pneumonia.
  • Iatrogenic, eg chest drain, tracheal laceration.
  • Migrating foreign body.

Pathophysiology

  • Rib fracture, chest wall damage, ruptured bulla, migrating foreign body   →   damage to visceral pleura, chest wall, diaphragm, esophagus, trachea (   →   mediastinum)   →   air enters pleural space.
  • Thoracic compression with closed glottis   →   increased transpleural pressures   →   ruptured lung or bronchus.
  • Small hole   →   spontaneous closure   →   reduced lung expansion.
  • Large hole   →   continual leakage air   →   collapsed lung.
  • Hole acts as one-way valve   →   air pumped in by lungs   →   supra-atmospheric air pressure   →   lung pushed to side and chest wall bulge = tension pneumothorax  Tension pneumothorax.

Timecourse

  • Acute.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Cooper E S, Syring R S & King L G (2003) Pneumothorax in cats with a clinical diagnosis of feline asthma: 5 cases (1990-2000). J Vet Emerg Crit Care 13 (2), 95-101 VetMedResource.
  • Fossum T W, Fellman M, Relford R L et al (1993) Eosinophilic pleural or peritoneal effusions in dogs and cats: 14 cases. JAVMA 202 (11), 1873-1876 PubMed.

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