What is a Fibrothorax?

What is a Fibrothorax?

Fibrothorax is scarring or fibrosis of the visceral pleural caused by inflammation from pleural disease.

Is decortication a major surgery?

Lung decortication is a simple yet formidable procedure. It involves the excision of the thick fibrinous peel from the pleural surface, thereby permitting the expansion of the underlying lung parenchyma.

How is decortication performed?

Decortication can be performed using the following methods: minimally-invasive (small incisions of 2–3 inches long / general anesthesia), or open-surgery (large incisions of 8-10 inches long / general anesthesia). The type of method chosen will vary based on your medical condition.

Why is Decortication performed?

The goals in performing decortication are to remove all the fibrinous peel and necrotic tissue, to help the lung reexpand, and, equally important, not to leave any residual air spaces. The two most common problems encountered in performing decortication are pleural-cavity infection and fibrosis.

What is cardiac decortication?

Cardiac decortication (epicardiectomy) was performed whereby a thickened peel encasing the heart was surgically excised, resulting in vigorous contraction and expansion of the heart. In one patient, decortication occurred early after pneumonectomy and was incomplete.

How is Hemopneumothorax treated?

The main treatment for hemopneumothorax is called chest tube thoracostomy. This procedure involves placing a hollow plastic tube between the ribs into the area around the lungs in order to drain the air and blood. The tube may be connected to a machine to help with the drainage.

Which is the best way to treat fibrothorax?

Today, an established fibrothorax is optimally managed by thoracotomy and decortication of the lung. Timely evacuation of hemothorax, empyema, or large pleural effusions with expansion of the underlying lung is critical in the prevention of fibrothorax.

What kind of inflammatory disease is fibrothorax associated with?

Fibrothorax is defined as fibrosis within the pleural space, and occurs secondary to the inflammatory response to one of the following events: tuberculosis / tuberculous pleuritis – particularly as a late sequelae 3. thoracic empyema. asbestos related pleural disease. rheumatoid arthritis. haemothorax.

How does fibrothorax cause breathlessness in the chest?

Within the chest, the lung is compressed and unable to expand (trapped lung), making it vulnerable to collapse and causing breathlessness. Restrictive lung disease from fibrothorax may occur when pleural fibrosis is so severe that it involves the diaphragm and ribcage and results primarily from decreased rib movement.

What does a chest radiograph show for fibrothorax?

Patients with fibrothorax may be asymptomatic or complain of dyspnea. The chest radiograph typically shows concentric pleural thickening, occasionally with evidence of the predisposing cause. Reduction in the size of the hemithorax with an elevated hemidiaphragm suggests chronic fibrosis.


What is a fibrothorax?

What is a fibrothorax?

Fibrothorax is a condition characterized by accumulation of fibrous tissue in the pleural cavity in reaction to undrained pleural fluid. A thick “peel” is formed on both pleural surfaces, eventually preventing complete expansion of the lung.

What causes a fibrothorax?

Common causes of fibrothorax or diffuse pleural fibrosis (Box 18-9) include organized hemorrhagic effusions, tuberculous effusions, pyogenic empyema, and benign asbestos-related pleurisy. When it is bilateral, it may produce a restrictive defect leading to respiratory compromise and occasionally to respiratory failure.

What is vocal resonance of auscultation?

Vocal resonance is an assessment of the density of lung tissue, performed by auscultating the chest and asking the patient to speak. Increased vocal resonance suggests increased density, while reduced vocal resonance suggests an increase in the amount of air present.

What is decreased vocal resonance?

A decrease in vocal fremitus suggests air or fluid in the pleural spaces or a decrease in lung tissue density, which can be caused by diseases such as chronic obstructive pulmonary disease or asthma. Inspection: Diminished chest movements on the affected side. Palpation: Diminished chest movements on palpation.

Is Fibrothorax a trapped lung?

Within the chest, the lung is compressed and unable to expand (trapped lung), making it vulnerable to collapse and causing breathlessness. Restrictive lung disease from fibrothorax may occur when pleural fibrosis is so severe that it involves the diaphragm and ribcage and results primarily from decreased rib movement.

Is sarcoidosis a lung disease?

Sarcoidosis is a rare disease caused by inflammation. It usually occurs in the lungs and lymph nodes, but it can occur in almost any organ. Sarcoidosis in the lungs is called pulmonary sarcoidosis.

What is pneumoconiosis caused by?

The primary pneumoconioses are asbestosis, silicosis, and coal workers’ pneumoconiosis (commonly referred to as CWP or black lung). As their names imply, they are caused by inhalation of asbestos fibers, silica dust, and coal mine dust.

What is Rhonchi?

This is a low-pitched sound that resembles snoring. Wheezing. This is a high-pitched sound, almost like a long squeak, that can occur as you inhale or exhale. Stridor.

How do you test for vocal resonance?

Assess vocal resonance Assessing vocal resonance involves auscultating over different areas of the chest wall whilst the patient repeats a word or number consistently. The presence of increased tissue density or fluid affects the volume at which the patient’s speech is transmitted to the diaphragm of the stethoscope.

What is trapped lung syndrome?

Trapped lung is one of the outcomes of fibrinous or granulomatous pleuritis and is a cause of chronic, benign, unilateral pleural effusion. It is characterized by inability of the lung to expand and fill the thoracic cavity due to a restricting fibrous visceral pleural peel.

How long can you live with trapped lung?

The management of MPE in the presence of trapped lung is hugely challenging because these patients generally have a poor long-term prognosis with a median survival time of 7 months for mesothelioma up to ∼30 months for metastatic breast carcinoma (7,8).