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Pneumotorace spontaneo
Emergency Surgery DPT(Chairman Prof M Taffurelli)
St Orsola-Malpighi University HospitalBologna ITALY
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IL TORACE
SPAZIO PLEURICO
POLMONI
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LO SPAZIO PLEURICO
SPAZIO PLEURICO
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PNEUMOTORACE
pnx
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CLASSIFICAZIONE PNX
FISIOPATOLOGICA
EZIOLOGICA
Spontaneo
Traumatico
Iatrogeno
Aperto
Chiuso
Iperteso (con meccanismo a valvola)
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IL PNX IN RADIOLOGIA
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IL PNX IN RADIOLOGIA
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PNEUMOTORACE IPERTESO
Grossi vasi compressi
Polmone compresso
Vene cave compresse
Cuorecompresso
Spazio pleuricoriempito
d’aria
polmone collassato
diaframma
Spazi intercostalirigonfiati
Sede della ferita
Muscoli rigonfi nella reg. sovraclaveare
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PNEUMOTORACE IPERTESO
continuo richiamo di gas dall'esterno verso il cavo pleurico
spostamento del mediastino spostamento del mediastino collasso delle vene cavecollasso delle vene caveriduzione dell'afflusso di sangue al cuoreriduzione dell'afflusso di sangue al cuore
aumento pressione endopleurica
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IL PNX IPERTESO IN RADIOLOGIA
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POSIZIONAMENTO DEL DRENAGGIO
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POSIZIONAMENTO DEL DRENAGGIO
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POSIZIONAMENTO DEL DRENAGGIO
tubo di drenaggio
pnx polmone riespanso
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DRENAGGIO PLEURICO CONTINUO
= un sistema che consta di = un sistema che consta di 3 elementi:3 elementi:
il catetere il sistema delle bottiglie
il sistema di connessione
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Il CATETERE o TROCAR
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…e dopo il DRENAGGIO…
…una o più BOTTIGLIE…
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IL SISTEMA DELLE BOTTIGLIE
Spazio pleurico
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LA VALVOLA AD ACQUA
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LA VALVOLA AD ACQUA
inspirazioneinspirazione
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LA VALVOLA AD ACQUA
espirazioneespirazione
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SISTEMA DELLE
BOTTIGLIE
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SISTEMA DELLE
BOTTIGLIE
PLEUREVAC
ABC
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IL PLEUR-EVAC
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FILTRO AD FILTRO AD ACQUAACQUA
RIEMPIRE LA CAMERA SINO A 2cmH2OIL FILTRO IMPEDISCE IL RITORNO DELL’ARIA NEL CAVO PLEURICO
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CAMERA DI CAMERA DI ASPIRAZIONEASPIRAZIONE
RIEMPIRE LA CAMERA SINO A –20cmH2OLA FORZA DELLA ASPIRAZIONE TORACICA E’ DETERMINATA DAL LIVELLO DI H2O NELLA CAMERA DI ASPIRAZIONE
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CAMERA DI CAMERA DI RACCOLTARACCOLTA
RACCOGLIE TUTTO IL LIQUIDO CHE SI FORMA NEL CAVO PLEURICO
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Terapia chirurgica delle bolle polmonari
Bullectomia polmonare per via toracoscopica
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