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TENSION PNEUMOTHORAX
Pediatric Res irolo D
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Helmi Lubis, dr, SpAK
Ridwan M. Daulay, dr, SpAK
Wisman Dalimunthe, dr, Sp
Rini S. Daulay, dr, M.Ked(Ped), S
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Pneumothorax
Accumulation of extra pulmonary air
within the chest
Uncommon durin childhood
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Result from leakage of air from withi
lung
Air leaks:
SpontaneousTraumatic
Iatrogenic
Catamenial
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Spontaneous Pneumotho
Primaryoccurs without trauma or
underlying lung disease
Secondarcom lication of underl
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lung disorder but without trauma:Pneumonia
Pulmonary abscess
GangreneInfarct
Asthma
Foreign body in the lung
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Traumatic Pneumothorax
External chest / abdominal blunt /
penetrating traumatear a bronchus or
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pleural space
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Iatrogenic Pneumothora
Complicate of:
Tracheostomy
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Transbronchial byopsi
Acupunture treatment
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Catamenial Pneumothorax
Unusual condition
Associated with menses
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air through diaphragmatic defect
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Clinical Manifestations
Pain
Dyspnea
Cyanosis
Involved lung:
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Decreased breath sounds
Percussion: tympanitic
Larynx, trachea and heartshifted
toward unaffected side
Gurgling sounds synchronous wit
respirationopen fistula connectin
with air containing tissues
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Diagnosis
Radiographic examination
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Evidence oftension:
Shift of mediastinal structure away f
the side of air leak
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Circulatory compromise
Hearing a hiss or rapid exit of the air
the insertion of thoracostomy tube
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Tension Pneuothorax cau
Limit expansion of contralateral l
May compromise venous return
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Definitive Treatment
Closed thoracotomy:
Drainage trapped air through a catheter
External o enin in a de endent os
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under wateradequate to re-expand thelung
Open thoracotomy:
Plicationof blebs
Closure of fistula
Stripping of the pleuraapical lung
Thoracoscopy
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Chemical pleurodesis:
Talc
Tetracycline
Silver Nitrate
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Pleural painanalgetic treatment:
Codeine
Morphine
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Recommended