- •Purulent diseases of lungs and pleura
- •Lung abscesses
- •Factors contributing to lung abscess
- •Factors contributing to lung abscess -2
- •Lung abscessess classification
- •Classification According to the character of purulent process:
- •Classification According to stages:
- •Classification Complications:
- •Symptomatology
- •Clinical manifistation of the first stage of acute abscess
- •Clinical manifistation of the second stage
- •Clinical manifestation at the third stage
- •Diagnostic procedures
- •Instrumental methods
- •X-ray examination
- •X-ray –frontal and lateral exam (2 plains)
- •Chronic abscesses
- •X-Ray chronic abscess
- •Lung gangrene
- •Differential diagnosis with Lung Carcinoma
- •The tactics in acute pulmonary destruction
- •Tactics:
- •Surgery, indications
- •Operations
- •Lateral thoracotomy
- •Posterolateral thoracotomy
- •Anterior thoracotomy
- •Pleural empyema
- •Etiology and pathogenesis
- •Classification (1)
- •Classification (2)
- •Classification (3)
- •Classification (4)
- •Symptomatology
- •Symptoms-1
- •Symptoms-2
- •Examination
- •X-ray examination
- •The diagnostic program
- •Chest X-ray presentation of pleural empyema
- •Pleural puncture
- •Local anestesia
- •Needle Positioning
- •Tactics and choice of treatment
- •Pleural drainage
- •Tactics and choice of treatment
- •surgery
- •Mediastinitis
- •Etiology
- •Mediastinitis originating from structures within the mediastinum
- •Descending necrotising mediastinitis
- •Symptoms
- •Investigations
- •X-ray examination
- •CT scans
- •Management
- •surgery
- •Prognosis
Purulent diseases of lungs and pleura
Ihor Vynnychenko,
Head of Surgery and Oncology
Department SumDU
Lung abscesses
•Lung abscess - necrosis of the pulmonary tissue and formation of cavities containing necrotic debris or fluid caused by microbial infection.
•Necrotizing pneumonia
•Lung gangrene
Factors contributing to lung abscess
•Oral cavity disease
•· Periodontal disease
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Gingivitis |
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Altered consciousness |
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Alcoholism |
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Coma |
• |
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Drug abuse |
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Anesthesia |
• |
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Seizures |
Factors contributing to lung abscess -2
•Immunocompromised host
•· Steroid therapy
• · Chemotherapy
• · Malnutrition
•· Multiple trauma
•Esophageal disease
• · Achalasia
•· Reflux disease
•· Depressed cough and gag reflex
•· Esophageal obstruction
•Bronchial obstruction
• · |
Tumor |
•· Foreign body
•· Stricture
Lung abscessess classification
Duration:
•Chronic
•Acute (4-6 weeks)
Etiology (Anaerobic bacteria)
Origin:
•Primary (infection +aspiration or pneumonia)
•Secondary (obstruction, spread from extrapulmonary site, immunocomprimized
Classification According to the character of purulent process:
•single purulent abscesses;
•- multiple purulent abscesses;
•- bilateral purulent abscesses;
•- gangrenous abscesses (single, multiple, uni- and bilateral);
•- limited gangrene;
•- wide-spread gangrene.
•
Classification According to stages:
•- 1 stage - necrotic pneumonia;
•- 2 stages - destruction and rejection;
•- 3 stages - cleaning and cicatrization.
Classification Complications:
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•pulmonary bleeding;
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pyopneumothorax; |
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pleural empyema; |
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sepsis; |
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bronchogenic dissemination. |
Symptomatology
•Depends on:
•on the size of the focus and
•character of destruction,
•reactivity of the organism and
•stage of the disease,
•peculiarities of the drainage of purulent cavities and
•complications.
Clinical manifistation of the first stage of acute abscess
•general weakness,
•headache,
•malaise,
•suppressed appetite,
•moderate chest pain,
•dyspnea,
•subfebrile temperature