Hydropneumothorax is defined as the presence of both air and fluid within the
pleural space. An upright chest
x-ray
An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
will show air fluid levels. The horizontal fluid level is usually well defined and extends across the whole length of one of the hemi
thorax
The thorax (: thoraces or thoraxes) or chest is a part of the anatomy of mammals and other tetrapod animals located between the neck and the abdomen.
In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main di ...
.
Signs and symptoms
This can be remembered by the 4 'S':
straight line dullness,
shifting dullness,
splash,
sound of coin.
Causes
*
Iatrogenic
Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence." Iatrogenic", ''Merriam-Webster.com'', Merriam-Webster, Inc., accessed 27 ...
: Introduction of air during
pleural fluid
The pleural cavity, or pleural space (or sometimes intrapleural space), is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable ...
aspiration in effusion
* Presence of a gas-forming organism
* Thoracic trauma
Diagnosis
Diagnosis can be via
CXR.
CT is better for outlining borders of air-fluid levels, however, CT has a greater radiation exposure.
Ultrasound imaging
Medical ultrasound includes diagnostic techniques (mainly imaging) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, join ...
has also proven to be a useful tool for hydropneumothorax diagnoses by looking for the absence of the characteristic "curtain sign" usually seen in ultrasound images at the base of healthy lungs.
Treatment
Treatment includes
intercostal drainage (ICD) of fluid and air and treatment of underlying conditions.
References
External links
Diseases of pleura
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