Gangrene of the lung: signs, causes, treatment

It is necessary to take care of the health of the breathing system from the youth. The human body is constantly attacked by various bacteria, viruses, microbes. Especially the risk of diseases increases during frosts and colds, which have replaced sunny warm days.

Air pollution, smoking exacerbate the condition and allow infections to penetrate significantly deeper into the respiratory canals. The disease affects the upper respiratory organs. Their weakness in combination with the inability of immunity to resist the attack of pathogenic microorganisms leads to the development of serious pathologies in the lower divisions. One of them is gangrene of the lungs.

What is an ailment? What are the symptoms of the disease? How to deal with it and can you defeat this unpleasant pathology? About everything in order.

Characteristics of the disease

What is gangrene of the lungs? It is a pathology in which the destruction of lung tissue occurs - necrosis. This process has a putrid character. Purulent tissue melting is not limited to a single site. The pathological process can rapidly spread, covering new zones. The disease can strike a few lobes, sometimes it spreads to the entire lung.

The affected tissue is brown. Inside, fetid pus is localized. Necrosis does not have strict outline, and, as mentioned above, has a tendency to proliferation.

Pathology is divided into 2 types:

1. Common: the localization of the disease is observed share.
2. Limited: a segmental location is detected. Often such a process is characterized as an abscess with a gangrenous character.

The disease is caused by a pathogenic microflora. Abscess and gangrene of the lung, in fact, are the stages of a single process. However, the first ailment is characterized by a limited purulent process in the tissues. Thoracic surgeons and pulmonologists refer these pathologies to the most severe and dangerous forms of destruction.

Most often, the disease is diagnosed in middle-aged men.

Gangrene of the lungs is an extremely dangerous disease. It often leads to fatal complications:

• Purulent destruction of the pleura;
• Pulmonary haemorrhage;
• Suppuration of the chest wall;
• Sepsis;
• Multiple organ failure.

About 60% of patients experiencing such consequences die.

Causes of the disease

Why does gangrene develop? The causes of the ailment are hidden in one single factor - infection of tissues. Often the microorganisms that provoke the disease are anaerobic bacteria.

An illness can be an independent pathology or a consequence of an organism intoxication. Thus, there are several mechanisms for the development of such a painful disease as gangrene of the lung.

The etiology of the disease is as follows:

1. Provoke the entry of microbes into the lungs and bronchi can cause gum disease, teeth, nasopharynx. In such conditions, the pathogenic microflora is able to spread down the respiratory tract.
2. Sometimes there is a penetration into the respiratory organs of the microscopic amount of the nasopharynx or contents of the stomach separated from the reflux, dysphagia, during vomiting. The latter phenomenon is often provoked by craniocerebral trauma or alcohol intoxication. Infiltrated in the bronchi aggressive contents of the stomach causes a purulent-necrotic process in the tissues.
3. Pathology can result from inadequate ventilation of the lungs. Such a condition often occurs when the bronchi are squeezed by a foreign body or a tumor. On this site, germs appear, and an abscess and gangrene begins to form.
4. The cause of the development of pathology can become purulent ailments of the bronchopulmonary system. These are the following diseases: bronchiectasis, pneumonia, lung abscess.
5. There is also a traumatic mechanism of gangrene development. The infection in the chest can be caused by penetrating wounds.
6. The pathogenic microflora is able to spread into the lungs through the system of lymphatic and blood vessels. This is observed with osteomyelitis, sepsis, parotitis, angina and many other pathologies.

An important role in the development of the disease is the weakening of immunity. In this case, the body is not able to fight microorganisms, and therefore can not prevent the occurrence of gangrene.

Allocate the following risk factors:

• smoking;
• alcoholism;
• addiction;
• HIV infection;
• Old age;
• The use of glucocorticoid hormones;
• diabetes.

Symptomatic of the disease

The lung gangrene differs quite rapidly. Symptoms are acute. The disease is rapidly progressing and the patient's condition is seriously deteriorating. Consider the clinical signs of gangrene of the lung.

Symptoms characterizing the disease look like this:

1. Painful discomfort in the sternum. It is significantly worse during coughing.
2. Severe condition of the patient: high fever, chills, pronounced intoxication of the body.
3. There is a lack of appetite, weight loss, including anorexia, tachycardia, dyspnea.
4. Intensive cough accompanied by frothy sputum and pus. The discharge is characterized by a fetid odor. They have a brown tint and a foamy layer. With gangrene of the lung in the sputum, particles of dead tissues, blood can be found.
5. The patient begins to suffocate.
6. Sweating is abundant.
7. Lack of oxygen leads to hypoxia, which is manifested by cyanotic fingers, skin and lips.
8. The patient is quickly tired.
9. Sometimes there is a confusion of consciousness.
10. The patient is painfully given a deep breath. Calm breath does not cause discomfort.

The course of the disease

Consider how the gangrene of the lung develops. The pathogenesis of the disease is very similar to the course of the lung abscess. Clinically, gangrene can be distinguished by a characteristic fetid odor and a high tendency to chronic process.

The disease manifests itself in this way:

1. Initially, the patient's temperature rises. The thermometer records high performance. However, this is typical of patients who do not have immunodeficiency. At the person the state of health worsens. He experiences severe weakness, nausea, lethargy. Often comes to vomiting. There is pain in the sternum. Trying to take a deep breath causes the greatest discomfort. If you press between the ribs, over the affected area, the person has pain.
2. Cough, as a rule, occurs immediately. Initially it is dry. Then it becomes wet. Coughing begins, which has an extremely unpleasant smell. If such a detachable is left in the tank for a while, then it will be divided into 3 layers. In the upper - will be observed foam with mucus. The middle layer contains a light liquid. The pus will fall out.
3. Symptom very quickly progresses. The patient develops shortness of breath, tachycardia appears, pronounced weakness. Consciousness of the patient is oppressed. In some cases, a coma develops. The temperature may drop. Sometimes it falls below 38 C. This condition is quite critical, since a large amount of infected content is absorbed into the blood.
4. If the patient survives in this period, then one or several abscesses form. Such cavities containing pus tend to break through into the bronchi. This phenomenon signals the next period of the development of the disease.
5. The patient develops or intensifies a cough, in which a large amount of sputum is released. If abscesses are emptied through large bronchi, then the patient immediately releases a lot of pus, in some cases with blood. The condition quickly improves. But most often, emptying does not happen directly, but through small bronchi. This greatly prolongs the release of the abscess from the pus, so the patient's condition continues to be severe. Sputum with gangrene of the lung has a foul odor. Sometimes it contains small fragments of lung tissue - sequesters.

Diagnosis of the disease

An important role in determining the pathology is played by physical examination. The patient has a lag in the process of breathing the affected part of the chest, shortens the percussion sound. During auscultation, respiratory weakened noises, dry rales are found.

In addition, the diagnosis of gangrene of the lung includes instrumental and laboratory methods of investigation:

1. Blood test. It shows an increase in the number of leukocytes, a decreased level of red blood cells, an increase in ESR. There is a decrease in the total protein of the blood.
2. An x-ray of the sternum. Gangrene and necrosis of the lungs appear in the picture by darkening the tissue. Often there are cavities of decay with uneven or scalloped edges. Darkening has a propensity for rapid spread and over the course of several days can affect adjacent parts, and sometimes all of the lungs. X-ray shows the appearance of effusion into the pleural cavity.
3. CT scan. This is a modern X-ray method. He is especially informative in this pathology. The tomogram makes it possible to detect all the decay cavities that correspond to the zones of melting of the lungs.
4. Fibrobronchoscopy. Endoscopic method of diagnosis determines purulent endobronchitis, obturation. The study provides an opportunity to observe the dynamics of the pathological process.
5. Sputum analysis. After bronchoscopy, the obtained contents and sputum are sent for laboratory tests. Diagnostic tests reveal the causative agent of pathology and allow to determine the sensitivity of microorganisms to antibiotics.

Possible complications

Only a timely appeal to doctors can stop such a pathology as gangrene of the lung. Complications arise, as a rule, if the visit to doctors is delayed.

In this situation, serious consequences can be observed:

1. Dry, exudative pleurisy.
2. A breakthrough into the pleura of the gangrenous cavity leads to pyopneumotorax. The patient has acute pain in the side, dyspnea appears, there is a displacement of the heart. The patient's condition deteriorates sharply. There are phenomena of collapse.
3. Profuse bleeding.
4. Septicopyemia. Pathology occurs against the background of destruction in the lungs of a large vessel.
5. Amyloidosis of the kidneys. Develops in the case of a chronic form of the disease.

In addition, with gangrene of the lungs, the risk of death is very high.

Conservative treatment

Therapy is performed in a hospital.

Treatment of gangrene of the lung consists of the following measures:

1. Intensive detoxification of the body. For these purposes, the patient is administered intravenously plasma-substituting low-molecular solutions: Gemodez, Reopoliglyukin, Neokompensan. Assign plasma, water electrolyte mixtures, albumin. Introduce glucose solutions (5%, 10%) with insulin, as well as inhibitors of proteolysis "Trasilol", "Contrikal."
2. Antibacterial therapy. This is the most important link, without which the treatment of gangrene of the lung is simply impossible. Initially, antibiotics are recommended that are characterized by a wide range of effects. As a rule, these are the following drugs: Fortum, Cefepim, Meropenem, Tienam. Often the patient is prescribed immediately 2 antibiotics. After determining the pathogen, a more accurate treatment regimen is selected. Sufficiently effective is the combination of the drug "Ampicillin" with the preparations "Tseporin", "Gentamicin", "Kefzol", "Tetraolean".
3. Desensitization of the body. The patient is prescribed medication Suprastin, Dimedrol, Pipolphen.
4. Vitamin complexes "Retinol acetate", "Riboflavin", "Cyanocobalamin", "Thiamine", "Pyridoxine", "Acid ascorbic acid" are recommended.
5. If there is a high coagulability of blood, the patient is injected intravenously with the drug "Heparin".
6. To ensure adequate breathing, periodically or constantly inhalation with moistened oxygen.
7. If necessary, they struggle with intestinal paresis, sanation of the tracheobronchial tree.
8. Prescribe phlegm liquor. These drugs are administered intravenously and used for inhalation. The patient can be recommended drugs "Ambroxol", "Lazolvan", "Ambrobene", "Khaliksol", "ACTS Inject".

During therapy, the patient's condition is strictly controlled. The functioning of the cardiovascular system, liver, kidneys is observed. The last organs are given special attention, because they provide the output of infected material and medicines.

Treatment of abscess and gangrene of the lung involves drainage of the cavity. Such an exercise is undertaken if the abscess is localized near the surface covered by the pleura.

Operative treatment

If the process can not be stabilized by conservative therapy, then all indications for radical intervention arise. For this, hemodynamic and metabolic disturbances are corrected, the patient's condition is assessed (can an operation be performed).

Surgical intervention involves the removal of gangrenous lung tissue:

• Lobectomy;
• Bilobectomy;
• Pulmonectomy.

Care of the patient

The disease is difficult enough for the patients themselves, and for people caring for them. It is very burdensome constantly present putrefactive smell.

Providing the necessary care to the patient, it is necessary to provide:

1. Use of deodorizing agents. In this role, creosote can act.
2. Near the patient's bed should always be a spittoon. To reduce the unpleasant odor, it is recommended to pour in a little deodorant solution. In addition, it must always be closed with a lid.
3. The patient, who is diagnosed with gangrene of the lung, is prone to profuse sweating. Therefore, the patient will often need to change bed and underwear.
4. Sometimes a person's condition deteriorates so much that he is not even able to take food himself. Therefore, those who care for such a patient, it is necessary to feed the patient with a spoon.
5. It is important to ensure complete physical and mental rest.
6. When hemoptysis the patient should be in a semi-sitting position.
7. The patient is not allowed to talk, use hot drink or food.

Forecast of life

What awaits those patients who have gangrene of the lungs? The forecast is disappointing only if there is no timely treatment. After all, the ailment grows very quickly, covering healthy areas. If conservative therapy does not help, and surgical treatment is not performed, the patient dies.

With timely access to doctors, a completely different picture is observed. Statistics say that in 70-80% of all cases, the patients perebaryvayut gangrene and recover. The course of complete and adequate treatment returns a person to a full life.

Special attention needs such complications as sepsis, pulmonary hemorrhage, multiple organ failure. With these ailments the patient needs emergency help. If for any reason it is not provided, then the risk of development of irreversible effects in the body is high.

That is why it is worth emphasizing again the following: in order to cope with this pathology, it is necessary to consult a doctor in a timely manner and fully comply with all the recommendations of doctors.