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Hydro and Pyopneumothorax causes,diagnosis and treatment

Definition
Hydrothorax means collection of fluid in the pleural cavity .
Pyopneumothorax means presence of air and pus in the pleural cavity .
Aetiology
(1) Introduction of air during aspiration of effusion or empyema.
(2) Empyema with broncho pleural fistula.
(3) Rupture of 1.8 cavity or lung abscess into pleura.

Clinical picture of Hydro and Pyopneumothorax

Symptoms:
- Symptoms of the cause +  dyspnea, cough

Signs
-lnspectlon    : Diminished movement of the affected side.
- Palpation    : TVF .t, shift of trachea to the opposite side.
- Percussion  : Basal dullness (not raising to axilla !?) with hyperresonance above, positive shifting dullness
-Auscultatlon  : .t.t intensity of breath sounds, +ve succusion splash.
Investigations:
-X ray chest showing pleural effusion with horizontal upper level + jet black zone above (air).
- CT scan chest.
Treatment
- Treatment of the cause.
 - Aspiration of (fluid and air)
-Intercostal tube can be used.
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Tamer Mobarak

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