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Classification: on

I. Pathogenesis
II. Character of pathological process
III. Condition gravity
IV. Complications

I. Pathogenesis

1. Bronchogenic (in-cluding aspirational and obturatio- nal)
2.Hematogenic (including embolic)
3. Posttraumatic

II. Pathological process character (abscess and gangrene only)

1. Acute purulent abscess
2.

III. Condition gravity

easy
middle
heavy

IV. Complications

1. Not complicated
2. Complicated (empyema of pleuras, pulmo-

lung abscess classification

Pathogenesis
Localization
Patient con- dition gravity
Clinical current
Complications

pathogenesis

postpneumonic
aspirational
hematogenic- embolic
traumatic

localization

segment, lobe, lung
peripheral, central
single, plural, bilateral

Condition gravity

easy
middle
heavy

clinical current

blocked, draining
acute, chronic

complications

Bleeding
Pyopneu- mothorax
sepsis

definition

The abscess of lung (a suppuration, apostema, an abscess) is a

exciting cause

More often activators of an abscess is pyogenic cocci, anaerobic

Infections ways

More often the pyogenic infection gets in pulmo- nary parenchi-

Infections ways

Direct infection of pulmonary tissue is possible at penetra- ting

Infections ways

It is necessary to note, that hit of pathogenic microflora

Infections ways

More often it arises at aspiration or mycroas- piration of sli- me,

Infections ways

Aspiration, as a rule, is marked at infringements of consciousness

Infections ways

Aspiration at times happens at dysphagias of various origin

Infections ways

After aspiration deve- lops atelectasis of the part of lung,

Infections ways

Indirect confirmation of the aspi- ration mecha- nism of occur- rence of pulmo- nary

drainage function

Infringements of drainage function lung are available at chronic nonspecific

background disease

Therefore, at the certain situations, some diseases promote occur- rence of

drainage function

Thus, owing to acute obstruc- tion of the bronc- hial tube draining

sepsis

At a sepsis are marked metas-tatic abscesses in lung. Heavy bruises,

causes

Hence, the reasons of pulmonary abscesses are diverse. Nevertheless, at their

60 and more
30-59
29 and younger

Clinical picture

Most frequently pulmonary abscesses meet at

Clinical picture

First of all it is caused by that among them

Adverse factors

Besides adverse production factors matter also: the dust content and

clinical picture

In a clinical picture of lung abs-cess are allocated two

Before break

For the first period is typi-cally acute beginning with rise

Before break

There may be pains in a thorax on the side

Before break

Infringements of the common condi- tion as a head- ache,

Before break

The clinic purulent-resorptive fevers is totally marked. At x- ray in

Before break

On the average, this clinic pro- ceeds within 7-10 days. As

Before break

after break

In the second period when an abs-cess evacuates through a

after break

In other cases discharge of sputum occurs gradually. At once

after break

The x-ray picture becomes typical for an abscess lung: there

after break

The cavity of an abs- cess eventually de- creases,

after break

In some situations it is formed thin-walled roun- dish formation

bad draining

In some cases, when it is marked bad draining of

bad draining

Clinically the constant disharge of purulent sputum is marked and

gangrenous abscess

Still allocate the gangreno-us abscess. As a rule, it is

pyopneumothorax

Sometimes the acute abscess of lung may break in a pleural

Radial methods

In diagnosis of pulmonary abscesses it is used roentgenography and

Conservative treatment

Conservative treatment of an acute abscess of lung includes three

draining

Sometimes bronchoscopy is car-ried out with cateterization of ca- vities of an abs- cess.

draining

In case of insufficient sanitation with the help of a puncture,

antibacterial therapy

Sometimes these preparations are entered in pulmonary and bronchial arteries,

general improving health therapy treatment

The pharmacotherapy is directed also on stimulation

acute abscesses

Hence, acute abscesses, as a rule, are trea- ted conservati-

Pleural drainage

Pleural drainage rules (K.Mattox)

1. NEVER just aspirate blood in a trau-matic

Pleural drainage rules (K.Mattox)

6. In teenage patients and adults for trau-matic

Pleural drainage rules (K.Mattox)

8. ALWAYS connect to suction at about 20

Pleural drainage rules (K.Mattox)

11. ALWAYS have the best person available to

sequestration in an abscess

At the sequestration in an abscess is possible

emergency operation

In the extremely rare cases when current of an acute

chronic abscess

The basic indication to operation is the chronic abscess. The

PLEURAL EMPYEMA

Empyema - a congestion of pus in a natural (anatomic)

Pleural empyema

The purulent pleurisy is the inflam-mation of pleural lists accompanying

Pleural empyema

Pleural empyema in 90% of cases is complication of purulent

Pleural empyema

To outpulmonary diseases resulting in development of pleural empyema, concern:

Classification of the pleural empyema

1. On clinical current
2. By the form
3.

Classification of the pleural empyema

1. On clinical current: the purulent-resorptive fever

Classification of the pleural empyema

4. On extent: limited, widespread, total.
5.

Classification of the pleural empyema

For the characteristic of intensity of purulent

Classification of the pleural empyema

Limited empyema are in cases of involving

Classification of the pleural empyema

To I degrees are referred those cases,

Classification of the pleural empyema

Introduction in classification of empyema with destruction

Classification of the pleural empyema

It is separately allocated empyema necessitas (perfo- rans)

pathogeny

As a rule, the purulent inflammation of pleura begins from fibrinous

Pneumonia and pleurisy

Pneumonias may divide on two groups: exudative type with

clinic

Clinical picture. At pleural empyema occur pains in a thorax on

clinic

The typical answer of an organism to any form of a

clinic

As it is marked above, frequently by the beginning empyema happens

clinic

In other cases the clinical picture of deve-lopment pleural empyema proceeds

clinic

At the acute form it is observed con-dition as a shock.

clinic

At the soft form, as a rule, an abscess evacuate in

clinic

The raised body temperature is one of the major attributes of

clinic

Frequently pains amplify at breath, there-fore patients avoid deep breath. Trying

clinic

Restriction of respiratory excursions of a chest is marked on the

diagnosis

One of the important methods of diag-nosis of the pleural empyema

diagnosis

Sometimes x-ray research will be carried out in lateroposition (on one

treatment

Treatment begins with a puncture of a cavity empyema. During a

treatment

After pleural cavity sanitation the drainage tube joins system active aspiration.

treatment

All patient will carry out intensive antibacte-rial treatment in view of

treatment

At destructions of the lung tissues, in necessary cases, bronchoscopic sanitation

chronic empyema

At chronic empyema pleuras operative treatment is shown. On the

chronic empyema treatment

As a rule, both operations (pleurectomy and decortica-

chronic empyema treatment

One of the most hardest operative interventions is pleuropulmonectomy.

bronchial stump unsufficiency

By the most often reason of a similar sort

chronic empyema treatment

Concluding this section, it is necessary to note, that

lung gangrene

Purulent-putrefactive necrosis of lobe or all of lung, with ab- sence

lung gangrene

As a rule, the gangrene is formed owing to putrid

lung gangrene

Etiopathogen moments of a gangrene in many re- spects are similar

lung gangrene

It is frequently marked aspira-tion on a background of alco-

lung gangrene

The significant role is played with previous chronic non- specific diseases

Clinic

As a rule, the gangrene of lung begins shar-ply, with significant

Clinic

Sometimes cough out small slices lifeless lung tissues. Even being on

Clinic

Frequently current of a gangrene of lung is complicated by development

Clinic

At percussion zones of dullness above lung are quickly increased. On

x-ray

At x-ray comes to light diffuse blackout of the struck parts

prognosis

The prognosis at a lung gangrene frequently adverse. Especially it concerns

gangrene lung treatment

It should be started with intensive therapy in reanimation

gangrene lung treatment

The main thing in treatment is stabilization of