Pathology of the Respiratory System | Pathologies and health.

• Atelectasis
• Pulmonary emphysema
• Pneumothorax
• Pneumonia
• Pleurisy
• Lung abscess
• Embolism and pulmonary infarction
• Pneumoconiosis
• Sarcoidosis
• Infections
• Wounds and injuries of the lungs and thoracic cavity
• Pulmonary cysts
• Lung Tumors
• Bronchitis
• Bronchiectasis

ATELECTASIS

What is atelectasis?

An alteration of the lung, which consists in the lack of dilation of pulmonary alveoli, to which an area is free of organ, namely air collapsed.

What is due?

From a blockage of the airway, usually one of the bronchial tubes, which prevents the air to reach the pulmonary alveoli.

There are different forms of atelectasis?

Yes:
congenital atelectasis), which may be due to the presence of mucus or meconium in a branch or bronchial and malformation congenital narrowing of one of these ducts;
b) acquired atelectasis, which can occur at any age and may be caused by occlusion of a bronco by mucus, pus or blood, or of small foreign bodies or Fragments of finished food by mistake in the bronchial tree. The first sign of the presence of a bronchial tumor, moreover, is often constituted by the discovery of
an area affected by pulmonary atelectasis, which in this case is the consequence of bronchial obstruction caused by the proliferation of tumour tissue.

What is the massive atelectasis?

Usually constitutes a post-operative complication, so one of the main bronchi is obstructed by a high amount of mucus, which can result in the collapse of an entire lung.

How is it treated?

Usually introducing a bronchoscope (see paragraph on the bronchi) in the patient's trachea and aspiring, by means of a special device, the mucus lump occluding the bronchial branch.

Massive atelectasis is a very frequent postoperative complication?

Since anaesthesia methods have been refined, not more. Today, in fact, provides anesthesia during and after the narcosis, keep the bronchial tubes using a tube, introduced into the trachea of the patient through the larynx.

Massive atelectasis is a serious condition?

Yes, because it can be associated with a high fever and breathing difficulties, and therefore complicate the postoperative course.

Can be successfully treated?

Yes; currently the aspiration of the lump of mucus and an antibiotic therapy can achieve recovery in almost all cases.

To remove the mucus that has caused this form of atelectasis, is always necessary to resort to the use of bronchoscope?

No; even the administration of oxygen and induce the patient to breathe deeply and cough can in many cases encourage spontaneous expectoration of mucus lump.
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PULMONARY EMPHYSEMA

What is emphysema?

The abnormal dilation of pulmonary alveoli (until you get to the SEPTA which separate break one pocket on the other), resulting in the loss of elasticity of the alveolar wall. It is usually associated with partial occlusion of bronchi, whereby air, while managing to penetrate into the lungs quite easily, I can instead be expelled except with extreme difficulty and ends so to remain "trapped" in the alveoli. Typical trouble of emphysema sufferer is the difficulty of exhale, or expulsion of air from the lungs.
If the process progresses, the lung parenchyma becomes stretched and stretched like a balloon.

What are the diseases that most often cause emphysema?

Chronic bronchitis and a persistent asthma.

What are the symptoms of chronic emphysema?

Increasing Dyspnea), i.e. difficulty breathing, characterized by increasing both the frequency and depth of breathing and associated with a feeling of oppression and lack of air;

b) cough;
c) cyanosis (bluish color of the skin, lips and fingernails), caused by insufficient oxygenation of the blood;
d) reduced oxygen supply to vital organs;
and in some cases), heart failure.

What tests diagnose emphysema?

Chest x-ray and spirometry; the latter assesses the amount of air you can exhale.

Emphysema progresses to the point that frequently result in heart failure and be deadly?

Usually, no; a similar deterioration is found in the 8-10% of chronic cases and progressive.

There are effective treatments for this disease?

A full-blown emphysema can be locked in its evolution, but not cured.
Depending on the case, mucolytic drugs are used, bronchodilators and inhaled corticosteroids. Great importance is also attributed to physiotherapy: specific breathing exercises can indeed reduce the symptoms.
A new treatment of severe emphysema is the application of CO 2 laser that is able to reduce the volume of the bubbles and saldarne tears.

You can prevent in any way the onset of emphysema?

Yes, treating promptly diseases such as bronchitis, asthma, sinus infections and bronchiectasis, and avoiding exposure to irritant factors such as smoke, chemical fumes and industrial dust.

Abnormally distended lung can rip?

Yes; the traction that the pulmonary parenchyma exerts on surrounding structures during
the breaths can lead to rupture of the cyst or emphysematous localized bubbles; If these are located near the pleura, you can have a sudden spontaneous pneumothorax, i.e. the penetration from the lungs of air in the pleural cable.
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PNEUMOTHORAX

What is a pneumothorax?

For pneumothorax is a collection of air within the pleural space, causing a partial or total collapse of the lungs. The pneumothoraces are classified into: traumatic pneumothorax (when are secondary to accidents or diagnostic maneuvers) and spontaneous pneumothorax (in absence of accidental or intentional injuries).

How can you tell a pneumothorax?

With sudden, violent chest pains, wheezing, sometimes with severe shock and collapse.

How is it diagnosed?

The doctor draws up diagnosing spontaneous pneumothorax based:
in) on clinical history of the attack;
b) about not warn, chest auscultation, the characteristic sound of the breath;
c) on enhanced resonance of sound produced by beating with the fingers on the patient's chest;

d) on radiography report, which highlights how a collapsed lung.
With collapsed lung emptying is defined for compression of the lung due to the recoil it suffers for its elasticity, when the pleural space is filled with fluid or air (pneumothorax).

How to treat spontaneous pneumothorax?

Because of the sudden shock and the severity of symptoms, is often required immediate hospitalization of the patient. If the extension of the collapsed lung exceeds the measurement of 25-30%, or the tear in the lung which does not heal-whereby air continues to enter the pleural cavity, causing a "pneumothorax"-it is necessary to introduce into the chest cavity through a small incision, especially practiced in the chest wall, a tube to drain the air and allow the lung, once healed the rupture , to widen again due to resorption of pneumothorax air; the cannula is left for a few days, so as to achieve healing of the lung parenchyma. In this maneuver are usually associated with symptomatic therapies to suppress cough and pain and, sometimes, the use of broad-spectrum antibiotics prophylactically. In some cases the laser treatment.

In which cases can produce a sudden spontaneous pneumothorax?

Idiopathic forms exist (not related to alterations in obvious respiratory diseases) and forms secondary to congenital or acquired pulmonary disease (including the most popular are the small bubbles sottopleuriche emphysema that may rupture spontaneously in the pleural effusion).

The collapsed lung can be deadly?

The prognosis depends on the amount of collapsed lung tissue. The interesting shapes both lungs, which are the only ones who can be lethal, are very rare.
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PNEUMONIA

What is pneumonia?

An inflammation, acute, usually of lung parenchyma. The inflammation can be caused by many different microorganisms.

Pneumonia can take different forms?

Yes; the different types of the disease are generally distinguished by which pathogens are causing, depending on that is caused by bacteria, viruses, fungi or other microorganisms. For convenience the pulmonary infections can be divided into two categories: community, if contracted through daily social relationships; hazard, if contracted in hospitals.

What is Interstitial pneumonia?

Is an inflammatory process that affects, initially, the thin connective tissue SEPTA separating the alveoli, and then spread, possibly to a whole area of the pulmonary parenchyma.

What is Lobar pneumonia, and what differences it has with respect to pneumonia?

Lobar pneumonia, or Pneumococcus (Streptococcus pneumoniae), usually affects one or more pulmonary lobes and is characterized by symptoms consisting of sudden onset of fever, shaking chills, accompanied by intense pain in chest (for the early pleural reaction), coughing and wheezing.
The pneumonia is an acute inflammation, caused by various pathogens affecting multiple foci in the form of small areas of the surrounding parenchyma Bronchioles; usually occurs more slowly than the Lobar form, in most cases as a complication of the flu or bronchitis.

Why the use of antibiotics reduced the incidence of Lobar pneumonia?

For the high susceptibility of the organism responsible for this form to antibiotic therapy.

What factors favour the onset of pneumonia?

Can a healthy person sick with pneumonia, but it is much more likely that this is associated with conditions capable of mitigating the defences of the organism, and in particular against respiratory pathogens (e.g., debilitating diseases, immunodeficiencies, neglected infections of the upper airway, foreign bodies in the bronchial tree, smoking).

What chance of recovery involves the disease?

Excellent; a time of pneumonias were deadly serious in about 25% of cases, while today the exitus is a rarity.

How long is pneumonia?

If cared for properly, can result in a period ranging from 5 to 14 days.

Once the illness, how long you should stay in bed and not leaving the House?

For at least two or three days after the temperature has returned to normal, and you can think of to get out of the House a few days after discontinuation of antibiotic therapy, if everything proceeds without complications.

Why nosocomial pulmonary infections are often more difficult to treat?

Because they are caused by bacteria become resistant to antibiotics in the hospital setting. In such cases appropriate sputum analysis, to identify objectively the microorganism responsible, and research of the same microorganism antibiotic is sensitive (antibiogram).

There are rare forms of pneumonia that does not react positively to antibiotic therapy?

Yes; those from viruses, because antibiotics are able to act effectively only on bacteria.

What is pneumonia "aspiration"?

For pneumonia "aspiration" itself is a form of inflammatory lung parenchyma caused by aspiration in the bronchial tree gastric acid content (e.g. vomiting), in patients with altered state of consciousness, anesthetized, with neuromuscular diseases or nasogastric tubes catheters were inserted. Speaking more generally, this group can be linked to inflammation include inhalation of toxic substances outside of whatever nature. Chemical damage to the respiratory tree may then easily overlap a bacterial infectious process.

The stay in bed for a long period of time may encourage the onset of pneumonia?

In some cases, elderly or bedridden for a long time due to serious diseases, circulatory stasis, which occurs at the level of most slopes of the lung parenchyma, may favor the superimposition of an infectious process.

Is somehow possible to prevent the onset of this form?

In many cases yes, curing the disease that underlies and inducing the patient bedridden to change position frequently. These patients should be made to lift as soon as possible.
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PLEURISY

What is the pleura?

A serous membrane consists of two laminae, or sheets: one, or visceral pulmonary, coating the lungs, the other, parietal, lining the chest cavity.
The two edges bounding the pleural cavity which under normal conditions is virtual and contains a small amount of serous fluid that allows mutual scrolling of those edges.

What is Pleurisy?

Inflammation, acute or chronic, pleura, which may occur as a disease in its own right (primitive), or secondary to various processes mainly dependent on the lung parenchyma.

From what can be caused?

In most cases by an infectious process (Koch's Bacillus, other bat teri, fungi, viruses). Among the other possible causes include tumors, collagenopathy, embolisms, intra-abdominal diseases, trauma, chronic respiratory failure.

Which takes the course Pleurisy?

Inflammatory processes may cause superficial, whereby on the pleura, a small amount of fibrinous exudate (fibrinous pleuritis or dry), or result in the pleural cavity secretion of serum-fibrinous exudate, whereby the Pleurisy takes the form defined serum-fibrinous or exudative.

What are the symptoms of Pleurisy?

The dry form usually begins with severe pain in the chest, which become more violent during inspiration (whereby the patient tries not to expand too much on chest), modesto fever and dry cough; This form can result in a few days, or become exudative Pleurisy.
In this case the pains and cough are less violent or disappear altogether and, in the case of a large pleural effusion, a Dyspnea may appear substantial, too.

How is it diagnosed?

The chest examination (inspection, palpation, percussion, auscultation) highlights is an inflammation of fibrinous type package is the presence of pleural effusion. The latter is then confirmed by chest x-ray. Examination (physical-chemical, bacteriological, cytological) of a sample of the deposit taken using exploratory puncture (thoracentesis), direct you towards a causal diagnosis more accurate.

What is a hysterectomy?

Is a procedure whereby, after a local anesthesia, a thin needle is inserted into the intercostal space to penetrate into the pleural cavity. In case of spillage, this technique is useful from a diagnostic point of view (the characteristics of the liquid) and, if the deposit is particularly impressive, ranging from therapeutic, favoring the reexpansion of the lung parenchyma.

Which course takes usually Pleurisy?

The dry form generally resolves within a short time; pleural inflammation associated with other lung diseases often disappear with the disease process that underlies: an exception in this regard is the purulent pleurisy, which can occur in conjunction with or as a result of pneumonia and other infectious processes and leads to the development of an empyema. The exudative form, that usually originates from a tuberculosis, can last for several weeks, until the pleural effusion is resorbed and the symptoms disappear. at the end of that disease process occurs not infrequently, more or less extensive formation of adhesions, fibrous tissue that connects the pleura lining the lung with the pleura lining the chest cavity.

How do we cure it?

Bed rest, at least until resorption of any payment.
Obviously, the secondary forms for other diseases include the targeted therapy towards the underlying cause, complemented by a symptomatic therapy of support towards the cough, shortness of breath and chest pains. In case of substantial deposits is indicated a thoracentesis and evacuativa if there is a risk of the formation of extensive adhesions, can be useful respiratory gymnastics.
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LUNG ABSCESS

What is a pulmonary abscess?

A pus-filled cavity formed in the lungs.

From what originated?

Usually, from an infection caused by microorganisms especially virulent to the lower Airways. Frequently can be secondary to the entrance in the Airways of infected material coming from the oropharynx, in people who, for whatever reason, have damaged permanently or temporarily the normal mechanisms of swallowing (neurological disorders, alcoholism, surgery).

Other mechanisms may also cause lung abscess?

Yes; These purulent cavities can form whenever you produce a local necrosis of lung parenchyma, for example in an inflamed area or affected by cancer.

How is the lung abscess?

in) on the basis of symptoms that, at an early stage of the disease process, can consist of fever, bruising and feeling unwell; in later stages can appear more or less intense cough with purulent sputum, smelling blood, sometimes accompanied by chest pain and dyspnea;
b) through: the lung x-ray has a characteristic appearance and purulent cavities is often clearly visible on radiography;
c) through a microscopic examination and sputum culture it is possible to identify the micro-organism responsible, being able to then implement a specific antibiotic therapy.

Is surgery always necessary?

No; Many lung abscesses heal fully with antibiotic therapy.
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EMBOLISM AND PULMONARY INFARCTION

What are heart failure and pulmonary embolism?

For pulmonary infarction refers to ischemic necrosis of a portion of paren chima, caused by a considerable impairment of blood supply to that area; If the lung area affected is small, there is talk, however, of a pulmonary embolism.

What are caused?

Most commonly the cause is to be found in an embolus, which is a fragment of a thrombus (blood clot) formed into a peripheral vein. This piece comes off from the clot and is transported away.

That destination has the embolus?

The embolus is carried by the blood stream until you get in a jar. The tissue that lies over the occluded point is thus deprived of spraying and die (necrosis).

Whence come these thrombi usually?

From blood clots formed in the veins of the legs or pelvis during various morbid processes or as a complication of surgery, and from which came off portions (defined precisely emboli), subsequently transported by the blood stream.

The formation of blood clots in veins of the legs or pelvis causes always and necessarily pulmonary infarction?

No; in most cases, the clot is located at the point of training and it rarely happens that you tear, resulting in a clot.
Also the size of emboli can be so modest as to allow their spontaneous disintegration or occlude the finer branches of the pulmonary circulation, not reaching the full-blown picture of pulmonary infarction, but merely cause of thromboembolism consequences much more limited.

How does pulmonary infarction?

Depends on the size of the blood clot from occluded blood vessel and the speed with which embolism occurs. Symptoms may be more or less intense pains in the chest, difficulty
breath, coughing, expectoration and fever; in some cases leads to a severe State of shock or sudden death.

This stroke can be detected radiographically exam?

Often in larger ones, 12-36 hours after the heart attack, the chest radiograph is a matte area at infarcted area.
In smaller cases or in case of pulmonary embolism, the radiographic findings may be normal.

Is somehow possible to avoid a pulmonary infarction in patients with Thrombophlebitis (inflammation of a vein) in the legs?

Yes; in most cases it is a workable anticoagulants (heparin or other anticoagulants) to prevent the extension of the thrombotic process, reducing the risk of pulmonary embolization.

What are the chances of healing in case of pulmonary embolism?

In most cases, good; at one time, these were fatal embolisms in approximately 15% of cases, incidence was reduced to just 1% by the use of anticoagulants.

In the case of pulmonary infarction, bed rest is important?

Yes; the patient is in a respiratory and cardiocirculatory situation that does not allow overworked caused by even minimal physical activity.
The most important is bed rest, though, establish early a anticoagulant therapy
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PNEUMOCONIOSIS

Prolonged inhalation of dust causes always and necessarily a lung disease?

No; many types of dusts, fumes and vapors can be inhaled for along time without giving rise to any disease of the lungs. The damage is more in relation to the quality of powder that the length of the exposure period.

What are almost harmless powders?

Those arising from welding and iron from soil particles.

What action on the lungs of coal dust?

Does not cause any symptoms, but settling on the lung parenchyma, makes these bodies a black coloration. This was a peculiar time of those who worked in coal mines, and is now a common feature of all those who live in the city.

What are some of the most harmful dust?

Those that contain silicon dioxide (quartz in nature), asbestos, talc, bauxite, beryllium (metal used in the electrical industry and mechanical), heavy metals (e.g., tungsten).

What is the most severe pneumoconiosis?

Silicosis, which is caused by inhaling silica, crystalline powder. Hitting those working in mines, quarries, factories of tiles, clay, ceramics, glass and sandblasting operations and grinding.

How long must be inhaled this substance before cause of symptoms?

The speed of development of the disease depends on the amount of silica dust inhaled.
There are chronic forms in slow development in need of 15 exposures and more years before the onset of clinical symptoms (and radiological); accelerated forms (5-15 years) and acute (within 5 years of exposure).

What are the symptoms of silicosis?

Initially the symptoms can be similar to that of a chronic bronchitis cough with sputum and dyspnea on exertion.
The disease has a tendency to move towards a framework of respiratory failure caused by massive pulmonary fibrosis which can lead to varying degrees of incapacity for work. It should also be remembered the frequent overlap of infectious phenomena in subjects suffering from silicosis. Is not described an increased incidence of lung Neoplasms associated with this disease.

How is it diagnosed?

According to the report, x-ray that highlights the characteristic appearance of the lung disease clinical history and examination of dust samples taken at work.

You can prevent its onset?

Yes, adopting both measures guaranteeing working conditions as much as possible, be appropriate protective equipment such as masks, Aspirators etc.
Taking into account that one of the major dangers of silicosis is the fact that this very often becomes complicated pneumoconiosis with tuberculosis, in Italy by law is required an annual visit with schermografia for all workers exposed to the risk of silicosis and expulsion from work that involves inhaling harmful dust all those showing symptoms of tuberculosis infection.

Is there a therapy against silicosis?

No. Once the process of pulmonary fibrosis is started, lung function, you can no longer stop it. The only measure you can take is to safeguard patients by continued inhalation of dust, not aggravate lung pathological condition.

What is asbestosis?

A pneumoconiosis due to chronic inhalation of asbestos dust (asbestos) that goes into various processes; gives rise to symptoms similar to that of silicosis.

Exposure to asbestos dust represents a risk factor for lung cancer and pleural mesothelioma?

Yes, no doubt. The World Health Organization, in the early 1980s, he defined the asbestos "carcinogenic to the respiratory system of man".
In Italy, a 1992 law prohibits the extraction, processing, use, marketing and processing, while a decree of 1994 provides guidelines for the reclamation of building structures, taking into account that in the past, asbestos was one of the most widely used materials for thermal and acoustic insulation.

What is the silo filler's disease?

Is lung disease typical of those who, working in silos or in industries where you use nitric acid, are subject to exposure to fumes containing nitrites and nitrates, resulting in toxic type pulmonary damage.
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SARCOIDOSIS

What is Sarcoidosis?

It is a systemic disease of unknown cause, characterized by the presence of granulomas distributed, more frequently at the level of the pulmonary parenchyma, lymph nodes, skin and eye (less common is the involvement of the heart, nervous system, kidney, liver, bones and joints).

You can be confused with other diseases?

Yes. The common forms are differentiated from other diseases such as lymphoma, other cancers, disseminated TB, brucellosis, toxoplasmosis and Vasculitis. Localization may show pulmonary radiological paintings similar to pneumoconiosis or TBC.

What important differences compared to Sarcoidosis has tuberculosis?

The absence of tubercle bacilli (Bacillus of Koch), sputum negative tuberculin test and histological differences when the typical granulomatous lesions are observed under the microscope.

Sarcoidosis makes unable to work?

It is especially the degree of pulmonary involvement can interfere with the working capacity of the subject. Typical of Sarcoidosis is the lack of symptoms in spite of an obvious radiological pulmonary involvement framework.
Sometimes, though, you can achieve widespread cases in which they seriously compromised the functional capacity of the lung (respiratory failure and possible heart failure secondary), with entity's inability to perform physical activity.

How you can diagnose it with security?

Diagnosis is made by evaluating clinical, radiological aspects, but especially with microscopic examination of a tissue fragment containing the characteristic Nodular lesions. There is also a specific skin test (Kveim test) but did not find wide application for the difficulty of finding the Antigen needed.
Very important, especially for therapeutic purposes, is the assessment of disease activity. This information is provided by way of an enzyme assay in the serum of patients (ACE) pulmonary scintigraphy with gallium 67 and examination of broncolavaggio alveolar (BAL) performed bronchoscopically.

There are preventive measures or a specific therapy against Sarcoidosis?

No. The cause is unknown and there is no possibility to prevent this disease. Acute course forms have a high incidence of spontaneous remissions, while chronic forms benefit from steroid therapy which acts automatically, dyspnea, and prevents excessive pulmonary fibrosis. This treatment also acts on almost all manifestations of sarcoidosis extratoraciche.
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INFECTIONS

Which lung infections may require surgery?

Abscesses). Although most lung abscesses is now successfully treated with antibiotics, in a number of cases still require their surgical drainage. This type of lung infection was associated with a high mortality rate, but today, thanks to modern techniques and the use of antibiotics, it reaches virtually healing in all cases.

b) unilateral Bronchiectasis. These morbid processes are characterized by dilation of the Bronchioles, which results in the partial destruction of their wall and makes them particularly susceptible to infection. If the bronchiectasis gives rise to a chronic infectious process, it is often necessary to remove the affected lung portion, i.e. make a Lobectomy: surgery that doesn't involve hazards and offers a good chance of healing.

c) empyema. This disease, which is characterized by the formation and accumulation of pus in the pleural cavity, was once one of the most frequent complications of pneumonia, while today there is seldom enough, thanks to the effectiveness demonstrated by antibiotics in the treatment of pneumonia. If, however, this lung inflammation is neglected or not treated properly and consequently develops an empyema, usually to drain the pus or by thoracentesis or practicing an incision in the chest, leading up to the pleural cavity, allowing emptying.
Both methods lead to healing in almost all cases.

d) tuberculosis. Surgical treatment of this lung disease includes many operative techniques, including excision of a lobe (Lobectomy) or the entire affected Lung (pneumonectomy): actions which are usually recommended only in cases where the disease process
do not have interested the other lung. Fortunately, the discovery and diffusion of anti-tuberculosis drugs have made similar unnecessary surgery in a high percentage of cases. Today has surgery in tuberculosis an application exception.
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WOUNDS AND INJURIES OF THE LUNGS AND THORACIC CAVITY

The wounds of the lungs or chest cavity are very common?

Yes. There is an alarming increase in accidents involving injury and pulmonary and thoracic.

What are the most frequent injuries of this type?

in) chest bruising;
b) or fractures of the sternum;
c) of a lung laceration, caused by the sharp edge of a fractured and voluptuous ambience in the lung parenchyma;
d) accumulation of air, or blood in the pleural cavity, both which may occur as a result of a lung perforation or penetration of a foreign body in the chest wall;
and collapsed lung), produced as a result of a spontaneous tear or bleeding;
f) gunshot wounds or cut.

You can save a person who has suffered a serious wound to the lung or chest cavity?

Yes; contrary to popular belief, an appropriate surgical intervention to save the patient's life in most cases.

How to treat wounds and injuries both thoracic and lung?

at First you must battle) the State of shock that usually accompanies such accidents: blood transfusions, oxygen administration, analgesics and sedatives are some of the measures with which you started therapy;
b) if the chest wall has a hole or an open wound, you must immediately cover the area affected, to prevent air from penetrating into the thoracic cavity. In such a case, as emergency measures, it is necessary to apply a bandage on the wound firmly, done with gauze and plaster (in case of need, even with a torn shirt); the important thing is that the aperture is closed;
c) If you have produced a severe pulmonary hemorrhage with accumulation of blood in the chest cavity, usually a thoracentesis, to suck the blood so raccoltosi. If, however, the bleeding does not stop, you may need surgery to stop the bleeding by blood vessels affected ligament, suture removal or lung injury portion;
d) If you have produced a spontaneous pneumothorax, it removes the air accumulated in the pleural cavity, introducing a needle or a small rubber tube into the chest cavity and then connecting it with suction equipment.
This allows the collapsed lung to expand again and resume working.
and when you're) produced in an extensive lung laceration, it may be necessary to effect its removal.
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PULMONARY CYSTS

Full dossier

What are pulmonary cysts?

Bags with a rather thin wall and containing air or liquid, which usually represent a congenital malformation. Some cysts are asymptomatic, while others either compress the blood vessels surrounding both the surrounding parenchyma, sometimes causing them to collapse.
Sometimes, but rarely are the expression of the presence in the lung of a parasite, Echinococcus forming around him a cystic cavity.

Pulmonary cysts may become infected and result in abscesses?

Yes; Some may also tear and allow air to flow so they contain, which accumulates in the chest cavity.
In the case of Echinococcus cysts, breaking them can lead to a spread of the parasite within the lung.

How to treat?

If causing symptoms, surgical intervention is appropriate, removing both the cyst and the surrounding parenchyma, i.e. through a so-called segmental resection.

Pulmonary cyst excision leads to satisfactory results?

Yes; in most cases you reach in this way fully recovered.
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LUNG TUMORS

All lung cancers are malignant?

No; can develop benign growths (adenomas), but malignant tumors are unfortunately more frequent.

Lung cancer is very common?

Yes, it is one of the most frequent forms of cancer and most often affects males, especially after 50 years, although since the 1980s the incidence declined in males and increasing in women. In Italy every year by 40,000 to 50,000 new cases.

Heavy smokers are more prone to lung cancer for people who do not smoke?

Yes, no doubt; It is estimated that in people accustomed to smoke a high number of daily cigarettes, this tumour reaches a percentage ten times higher than that in non-smokers. Moreover, although it has not been established with certainty, that secondhand smoke, i.e. inhaling smoke of cigarettes smoked by others, may increase the risk of developing lung cancer.

In addition, there are other risk factors?

Yes: pollution, exposure to radon (gas emitted from the Earth's crust and infiltrating in buildings), exposure to certain chemicals such as asbestos, radiation exposure.

What are the early symptoms of lung cancer?

persistent cough);
b) expectoration of blood (hemoptysis);
c) characteristic lung shadowing hit detectable on x-ray.
Belatedly, can also see chest pain. Often associated with fever and weight loss.

Is somehow possible to ascertain the presence of this new formation?

The most effective measure in this regard is to undergo medical examinations on a regular basis. Your doctor will decide then on whether to perform a lung x-ray. Radiographic positive, to define the characteristics of the tumor, you run another series of investigations: chest CT scan, bronchoscopy and needle biopsy TCguidata.
With these two latest diagnostic techniques, you can type the tumour and determine the stage of evolution.

What does "type the new formation"?

Lung cancer can consist of different types of cells. Squamous cell cancer consists of epithelial cells, from adenocarcinoma cells of glandular type; the tumor composed of undifferentiated type cells can be large or small and the latter (small) is the most aggressive cancer.

What are the stages of evolution of lung cancer?

The first stage covers of neoformations 3-4 '' that did not affect the mediastinum (the area between the lungs); the second stage, growths that have affected the lymph nodes pulmonary hilum (the area from which they ori gine and vessels
bronchi). The third stage is characterized by the involvement of ipsilateral Mediastinal lymph nodes (i.e. the same side), the third stage B from lymph nodes involvement also contralateral mediastinum. The fourth stage, finally, concerns large tumors that have given rise to metastasis.

What are the most likely sites of metastasis, and how to locate these secondary lesions?

The brain, bones, liver and adrenal glands. To locate them using cerebral CT scan, bone scan, and abdominal ultrasonography.

How to cure lung cancer?

If the tumor is at an advanced stage, by surgical excision of the lobe (Lobectomy) or the entire affected Lung (pneumonectomy).
Sometimes surgery is associated with radio-and/or chemotherapy.
Especially for small using chemotherapy and/or radiation therapy instead of surgery. There are also, in clinical trials, gene therapies to restore the activity of a particular protein (p53), which acts as a tumor suppressor, or inhibiting oncogenes.

Who underwent a Lobectomy, can breathe normally?

Yes; This surgery does not affect breathing, but reduces the ability to cope and sustain physical effort. Keep in mind that the chance to breathe, and then oxygenate the blood, are strongly reduced.

Pneumonectomy impairs the ability to live and breathe normally?

Not high. Who underwent a similar surgery should avoid physical activities that require great efforts, but can lead a normal life otherwise, nor has difficulty breathing if you excessively tired.

What fills the space created in the thoracic cavity after removal of a lobe or lung?

The empty space in the chest cavity is occupied by scar tissue; Meanwhile, the thoracic part drops, the diaphragm rises and the portion or the residual lung expand slightly.

The scars left from the chest cavity or lungs are very disfiguring?

Not overly. For these surgeries is an engraving, 30 to 35 cm, which stretches all the way back to the front of the chest; usually, however, such injury heals perfectly, leaving a thin line is not very disfiguring.

After a Lobectomy or pneumonectomy, the rib cage suffers a large strain?

No; When the patient is fully clothed, do not you realize at all that has been subjected to a similar surgery.

The thoracoplasty, i.e. excision of some coasts, results in an increased deformation of thoracic cage?

Not particularly; usually, such a deformation is known only when the patient is undressed.

Anesthesia plays a prominent role in operations in the chest?

Yes; anesthesia performed properly has a decisive importance for this type of surgery.

That period of hospitalization involves Lobectomy or pneumonectomy?

Roughly two weeks.

After an invasive chest surgery, you can leave the bed within a short time?

Yes, usually two or three days after surgery.

What chance of complete and final healing involves the surgical therapy of pulmonary diseases?

Tuberculosis: excellent) in most cases;
b) cysts: very good in almost all cases;
c) tumors: excellent with regard to benign growths. in the case of cancer, early diagnosis and improved surgical techniques show a constant increase of the survival index.
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BRONCHITIS

What is acute bronchitis?

An inflammation of the bronchial mucosa infectious source (but can have as predisposing factors or smoke inhalation of irritants), which usually occurs as a complication of a cold or flu.
In debilitated organism pathogens have better chance to take hold and cause inflammation. Acute bronchitis lasts however limited.

Which usually takes course?

A parallel to the course of infectious process that is at the origin, and disappears shortly after the conclusion of this. Bronchitis, however, must be treated in a specific way.

What time occurs more frequently?

During the winter months; When all are more frequent infections of the upper airways.

What are the most common complications of acute bronchitis?

Pneumonia and the transformation of chronic acute form.

What is the meaning of repeated attacks of acute bronchitis?

Particularly prone to recurrent episodes of acute bronchitis can be chronically exposed to irritant type bronchial mucosa, or carry a chronic outbreak of respiratory load.

What is the characteristic symptom of bronchitis?

A persistent cough with expectoration of mucus quantity variables.

A cough caused by bronchitis must be suppressed by the administration of appropriate medicines?

No; Although undoubtedly annoying, this symptom has a positive side, as it stimulates the expectoration of mucus masses that have accumulated in the bronchi.
May, if it proves particularly difficult expectoration, be useful drug delivery. thinners

In which case the acute bronchitis becomes chronic?

Acute bronchitis should not persist for more than 2-3 weeks; If, however, it attaches due importance, not by treating her properly or not by removing the conditions favoring a subsequent reinfection, can assume a chronic course.

If acute bronchitis doesn't disappear, what diseases should be taken into consideration, and what possible complications?

Pneumonia, tuberculosis, bronchiectasis, asthma, presence of a foreign body or even a tumor in her lungs.

Those suffering from bronchitis or persistent cough should undergo a radiographic examination?

In any case it must undergo thorough medical examination which may be supplemented by performing a chest radiograph.

When you are suffering from a disease of the upper respiratory tract (cold, flu, bronchitis) you can continue smoking?

No, because smoking exerts a particularly irritating action on the mucosa of the nose, throat, and bronchi; in this regard, it is also advisable to avoid too smoky environments.

What is "smokers cough"?

People accustomed to smoke excessively are often suffering from a persistent cough, which should not however be satisfied with simply irritating action attributable to smoking. Any person suffering from a similar ailment, whether or not it is a heavy smoker, should undergo a medical examination for ta Ta ensure that the origin of cough there's a bronchial or lung disease.

The quantity and characteristics of the sputum are important to assess the nature and extent of the disease-based?

Yes. In the presence of a simple bronchitis, sputum is usually poor. bronchiectasis is more abundant, more viscous and can have a yellow or greenish tint; in the presence of a lung abscess is smelly and sometimes contains blood: a characteristic, the latter, which normally occurs in tuberculosis, and often also in lung cancer. The expectoration of blood-tinged phlegm can also be caused by the rupture of a small vase, determined by strong cough. The fact, however, especially if it is repeated in the following days, must always be reported to your doctor.

The presence of blood in the sputum is always symptom of tuberculosis or lung cancer?

No; First you need to be sure that the blood really comes from the lower Airways (not, for example, gums, tongue, pharynx, from the nasal cavity or the digestive tract). In any case, can be caused by other pulmonary diseases (bronchitis, pneumonia, bronchiectasis, abscess and pulmonary infarcts, trauma) or be linked to cardiovascular disorders or bleeding disorders. However, the symptom should not be overlooked.

The presence of blood in the sputum always requires a further visit more accurate?

Yes; in such a case, it is absolutely necessary to go to the doctor, to clarify the cause of this phenomenon.

What is the Bronchoscopy?

An exam that consists of introducing into the trachea and bronchi of a special tool, called a bronchoscope. This consists of a metal tube, bearing at one end, a light source and a mirror, which allows you to see directly the walls of the trachea and bronchi. Today using fiberoptic bronchoscopes, thin and flexible, allowing direct visualization of the airway smaller caliber, as well as be much less troublesome to the patient.

What can detect with Bronchoscopy?

This review is of enormous importance to ascertain the exact nature of pulmonary diseases, which neither nor x-ray sputum analysis allow to diagnose with certainty. Allows to locate the point where bleeding occurred or a foreign object inhaled into the lungs; to discover the presence of bronchial cancer or to find the location of a lung tumour, as well as to see where bronchial occlusion is produced.

What other important issues presents the Bronchoscopy?

As well as diagnostic, inspection Bronchoscopy also lets
operate out of areas targeted biopsies from suspected appearance and to collect samples of selectively secretions that are then examined from the point of view both bacteriological and cytological examination.
Is also therapeutic applications in the removal of foreign bodies or secretions.
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BRONCHIECTASIS

What is bronchiectasis?

General or limited expansion, bronchi, in which stagnating secretions that cannot be eliminated spontaneously, caused by destructive alterations of elastic and muscular components of the bronchial wall.
The disease rarely affects profusely all the bronchial tree: in most cases is limited to a single segment or lung lobe.

How can they be the bronchiectasis?

At issue is the existence of congenital bronchiectasis. The origin of the destructive process is almost always linked to a bacterial infection.

What are the symptoms and complications give birth?

Chronic cough and persistent, usually associated with abundant mucus expectoration; difficulty breathing; emphysema; bronchial hemorrhages; Lung abscess formation; pneumonia.

A normal chest x-ray is sufficient to diagnose the bronchiectasis?

No; to confirm the clinical diagnosis in this case need to run both a bronchography is a Bronchoscopy.

What principles govern the treatment of bronchiectasis?

a) In the case of overlap, bacterial antibiotic therapy targeted as possible;
b) in any case away from smoky irritants and environments of all kinds;
c) mucolytic drugs to promote expectoration of secretions accumulated in the bronchi;
d) postural drainage: cough until it produces more sputum assuming a position for which the lung area affected by bronchiectasis is higher than the head. This exercise is repeated 4 times a day.

In the presence of bronchiectasis, it is sometimes advisable to surgical therapy?

Yes, in the presence of localized bronchiectasis (i.e. limited to a small portion of the lung) that do not respond adequately to medical treatment or that give rise to serious complications (massive or recurrent pneumonias emoftoe).

This is surgery dangerous?

No; Thanks to the improvement of surgical techniques, currently the interventions of Lobectomy and pneumonectomy can run without any risk by surgeons who specialize in this field.

What chance of healing involve similar operations?

If you removed all the diseased portions of the lungs, you reach the complete cure in over 95% of cases. Respiratory function tests, properly performed, can help determine the extent of pulmonary portion can be removed without any risk to the patient.
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