Spikes in the left and right lung: pleural, fibrous

A serious complication after respiratory diseases is a spike in the lungs. Consider the pathogenesis and the causes of their appearance, the main symptoms, methods of treatment and prevention.

Lungs are a paired organ in the chest that is responsible for the process of breathing. The right lung is more than the left lung by 10%, since the human heart is displaced to the left. The volume of the body is about 3 liters. On all sides of the lungs are covered with a pleural membrane. After extensive pneumonia and other inflammatory or infectious lesions, lobes can form between the lobes, that is, peculiar internal scars.

• The appearance of the adhesions depends on the organ where they formed. They can be thin like a plastic film or thick fibrous growths.
• Most often, the strands are localized between the serous membranes of the pleural cavity, and they are also detected in the diaphragm area.
• In especially severe cases of growth, all parts of the pleura take up, causing the adhesions of the pleural sheets and complete overgrowth of the cavities.

Adhesive disease can affect any organs where there is connective tissue. This pathology has a negative impact on the work of the whole body and especially the respiratory system. Growing up, moorings cut off blood vessels, disrupting circulation and causing discomfort during breathing, respiratory failure.

What are dangerous spikes in the lungs?

In most cases pulmonary moorings are formed during inflammatory and infectious lesions. The danger of adhesions is that the pathological process is hidden. Very often, signs of adhesion are covered under the symptoms of ARVI and other respiratory diseases. As the growth grows, the connective tissue strands disrupt the blood supply of the lungs and can cause the pleural cavity to form.

Another danger of the shvart is pulmonary and cardiac failure. These pathological processes lead to the development of pneumosclerosis, that is, the replacement of healthy organ tissues with connective. The disease threatens with such complications:

• Deformation of the lungs and bronchi.
• Disruption of gas exchange in the respiratory system.
• Oxygen starvation.
• Pulmonary hypertension.
• Accession of secondary infection.

All of the above factors negatively affect the overall health and work of the whole organism. Without timely diagnosis and treatment, there is a risk of death.

Epidemiology

As statistics show, the appearance of adhesions in the lungs is most often associated with the performed surgical interventions, traumas and inflammatory pathologies.

According to the study, the growths on the pleural membrane can progress for many years and do not reveal themselves. Only 20% of cases of pulmonary synechia lead to the adhesion of pleural sheets, respiratory failure and other life-threatening complications.

[1], [2], [3]

Causes of the adhesions in the lungs

Adhesions are an overgrown connective or fibrous tissue. Most often they are a complication of pleurisy or severe pneumonia of any etiology.

The main causes of adhesions in the lungs are:

• Bronchitis: acute, chronic.
• Pneumonia.
• Parasitic infections: ascaridosis, echinococcosis, amebiasis, paragonism.
• Infection of the lungs with a stick of Koch.
• Malignant processes.
• Sarcoidosis.
• Congenital anomalies of the organ.
• Lung infarction.
• Traumatic injuries.
• Internal bleeding.
• Occupational hazards (inhalation of dust and chemicals).
• Poor environmental situation in the place of residence.
• Bad habits.
• Surgical interventions on the chest.
• Allergic reactions and frequent inhalation of allergens.

If the sprouting is point or single, there are no painful sensations, but if the moorings are extensive, then this is accompanied by a pronounced pathological symptomatology. The presence of numerous adhesions leads to the exclusion of the light from the gas exchange process. Because of this, oxygen starvation, respiratory failure and deterioration of general health develops.

Regardless of the cause of origin, connective tissue fusion can become infected with advanced respiratory pathologies. Because of this, cicatricial changes tighten and deform the lungs, causing serious irregularities in their functioning.

Spikes in the lung after surgery

To date, there are minimally invasive surgical techniques that allow performing operations on the lungs through small incisions. But even laparoscopic intervention can cause postoperative adhesions.

All operations carried out on light operations are divided into two groups by volume:

• Pulmonectomy (pneumonectomy) - complete removal of the lung. It is prescribed for malignant lesions and numerous pathological lesions.
• Resection is the removal of a part of the organ.

Removing the lung, its segment or lobe causes serious pathological changes in the structure of the lung tissue. If the postoperative process is complicated by inflammatory reactions, then the synechia is formed.

Adhesive disease leads to a disruption in the supply of oxygen to the body. There is shortness of breath, increased weakness, chest pain, cardiovascular problems, dizziness. Postoperative period imposes a negative imprint on the entire body. There is a displacement of internal organs, blood supply changes.

Pleural adhesions limit the linear dimensions of the remaining parts of the lung. Because of this, the breathing process is disrupted. If the growths become infected, for example, because of a cold, it leads to intoxication of the body. To prevent postoperative complications, patients will have a long rehabilitation period with a course of physiotherapeutic procedures.

[4], [5], [6], [7], [8]

Risk factors

Expanded connective tissue pulmonary bands, most often located between the serous membranes of the pleural cavity. They arise because of a variety of reasons, there are also a number of risk factors for the appearance of this pathology:

• Chronic infectious-inflammatory lesions of the respiratory system.
• Mechanical injuries.
• Congenital and genetic pathologies.
• Radioactive irradiation.
• Allergic reactions.
• Syphilis.
• Tuberculosis.
• Operations.

Heavy there are any localization, they arise on the place where there is connective tissue. The defeat of the pleura can be total, affecting all parts of the organ and a single planar one. In particularly severe cases, there is a fusion of pleural sheets.

[9], [10], [11], [12], [13]

Pathogenesis

The mechanism of the development of adhesive disease has a biochemical basis. Grafting occurs after inflammatory and infectious diseases, injuries, surgical interventions. Before considering the pathogenesis of the formation of strands in the lungs, it is necessary to familiarize yourself with the peculiarities of the structure of this respiratory organ:

• The lungs and chest cavity are covered with pleura. It is a serous membrane of mesothelial cells with a fibroelastic framework. The framework contains nerve endings, lymphatic and blood vessels.
• The pleura consists of two layers: parietal and visceral. The first is the outer shell of the inner surface of the chest cavity, provides free movement of the lungs in the chest.
• The visceral layer envelops each lung to normal slip relative to each other. Both parts of the pleura are connected together. The visceral part has a double blood supply, receiving blood from the pulmonary and bronchial arteries.
• The pleural cavity and its leaves carry out an act of breathing. The cavities contain a liquid, which ensures the sliding of the sheets when inhaled and exhaled. The tightness of the organ is maintained by pressure.

Pleural adhesions most often serve as a complication of the transferred diseases: pneumonia, bronchitis, parasitic infestations. In this case, the adhesion process helps the body to localize the inflamed area. The formation of strands occurs with mechanical injuries, that is, injuries of the chest and after surgical interventions.

Connective tissue fissures disrupt blood circulation in the affected tissues. This leads to changes in the structure of the lungs and provokes painful sensations, malfunctions in the functioning of the organ. Moorings can be single and multiple. Their appearance threatens with violations of air exchange, oxygen starvation, incessant airway diseases.

[14], [15], [16], [17], [18], [19],

Symptoms of the adhesions in the lungs

In most cases, the enlarged connective tissue bands on the lungs do not make themselves felt. Symptoms that allow them to be suspected are manifested by various complications. Also, the symptomatology depends on the location of the splices, so the disturbances are quite diverse:

• Difficult and rapid breathing.
• Respiratory failure and shortness of breath.
• Cardiopalmus.
• Dizziness and loss of consciousness.
• Reduced blood pressure.
• Paradoxical movements of the chest with the participation of an auxiliary respiratory musculature.

A painful condition is accompanied by a deterioration in overall well-being and increased weakness. The appearance of the above symptomatology is the reason to immediately seek medical help for a diagnosis.

[20]

First signs

At the first stages, the disease state does not have pronounced clinical signs. Discomfort occurs with increased physical exertion, when the compensatory mechanisms begin to deplete. Many patients note the appearance of such symptoms:

• Dyspnea.
• Pain in the chest.
• Dizziness.
• Difficulty with restoring breathing.
• Cardiopalmus.

If the appearance of adhesions occurs with a secondary infection, then purulent sputum appears, increased cough and shortness of breath, increased body temperature. It is also possible the development of anemia with marked pallor of the skin.

As the growth of connective tissue strands painful symptoms increase:

• There is a psychomotor agitation.
• Skin and mucous membranes acquire a cyanotic shade.
• Reduced blood pressure.
• Possible loss of consciousness.

If the adhesions are the cause of the adhesion of the pleural sheets, the symptoms are acute and pronounced. Signs of the terminal stage of respiratory failure in combination with impaired gas exchange in the lungs, and acute shortage of oxygen cause serious disruptions in the work of other organs and systems.

[21], [22]

Spikes in the left and right lungs

The left lung differs from the right one in smaller sizes and shapes. It is a little longer and already right. The organ consists of two branches: the upper and lower lobes, which have an almost equal volume. The volume of the left bronchus is less than the right, while its length is twice the right one.

Spikes in the left lung are formed for the same reasons as in the right. It can be transferred and launched inflammatory lesions, chronic obstructive disease, fibrotic processes, trauma and a number of other pathologies. The symptomatology of left-sided lesion is characterized by discomfort on the left side, which can affect the cardiovascular system.

The volume of the right lung is more than the left one by 10%, but it has smaller linear dimensions. Such differences are associated with the displacement of the main muscle of the body (heart) in the left side, so there is more space on the right side. In addition, it is on the right side of the abdominal cavity that the liver is located, which presses the sternum from below, thereby reducing its height.

The organ has three parts, that is, parts that are functionally equivalent to one another. Each contains structural elements for gas exchange and full-scale work. In this case, the upper share differs from the rest not only in localization, but also in volume. The smallest in the middle lobe, and the largest at the bottom. Spikes in the right lung can occur on any of its branches.

Forms

Depending on the location and extent of prevalence, several types of connective tissue fusion in the lungs are distinguished:

• Pleuroapical.
• Pevropulmonary.
• Pleurodiaphragmatic.

Types of adhesions are classified according to the etiology of their origin:

• Infectious / non-infectious.
• Traumatic.
• Postoperative.
• Exudative.
• Fibrotic.
• Congenital.

Moorings are local, focal and multiple. Local are a limited altered area of lung tissue. They do not cause painful symptoms. Focal regions are localized in several parts of the pleura, and multiple chaotically cover most of the lung.

The type of adhesive disease is established during the diagnosis. The severity of the lesion and the severity of pathological symptoms depends on the form of treatment.

Pleuroapical adhesions in the lungs

The pleura of the pulmonary apex is the pleuroapical adhesions. Such stratifications can indicate recent inflammatory processes. But most often the moorings arise because of tuberculosis infection, that is, they act as its complication. Connective structures isolate the affected area from healthy tissues.

As a rule, the proliferation of tissues is revealed during fluorography. On their own, strands are not a disease, so they do not require therapeutic effects. If they cause pain in the chest, shortness of breath and other unpleasant symptoms, then medical help is needed.

[23], [24], [25], [26]

Pleuropulmonary adhesions

The appearance of pleuropulmonary cords in the lungs, indicates the previously transferred inflammatory processes with lesions of pleural tissues. Connective tissue fusion is due to impairment of respiratory and circulatory functions. Moorings localize affected tissues from healthy ones, thereby restoring the normal functioning of the organ.

The lungs are surrounded by a pleural cavity. Normally, this area contains about 5 ml of synovial fluid, which acts as a shock absorber for a normal breathing process. If the organ is sick, then inflammatory exudates appear, which provokes the development of pleurisy. In the process of illness, fibrin is deposited on the walls of the organ. During recovery, the inflammation goes away, and the accumulated liquid dissolves. But fibrin can remain in the pleura and cause adhesions. In especially severe cases, this leads to a fusion of the pleura.

As a rule, pleuropulmonary formations are revealed during fluorography. In most cases, this radiographic evidence does not require special treatment. The need for therapy occurs with the development of respiratory failure and other painful symptoms.

Pleurodiaphragmatic adhesions

The connective tissue at the boundaries of the serous membranes of the pleural cavity is the pleurodiaphragmatic moorings. In the lungs, they are formed due to inflammatory and infectious processes, as well as traumatic injuries and congenital anomalies. Spikes can be total, growing throughout the entire pleura and single.

If adhesions cause pain during breathing, shortness of breath, and other unpleasant symptoms, you should consult a pulmonologist. The doctor will prescribe a comprehensive diagnosis.

• If growths are associated with inflammatory processes, there is an increased white blood cell count in sputum, a change in the C-reactive protein in the blood.
• When studying sputum, the level of alveolar macrophages, bronchial epithelium, the presence of erythrocytes and other indicators are determined. If the analysis reveals an epithelium, then depending on what type of cells prevails, the doctor draws conclusions about the extent of the respiratory tract.
• Spirography with a bronchodilator is also performed to determine the functions of external respiration.

Treatment depends on the severity of the adhesions and the cause of its appearance. If there is a high risk of pulmonary insufficiency and other life-threatening pathologies, then surgical intervention is performed. In other cases, patients are prescribed medication and a course of physiotherapy.

Diaphragmatic adhesions

The diaphragm represents a plane muscle, which consists of several muscle bundles. It is located between the breastbone and the abdominal cavity, that is, right under the lungs, in contact with the pleura. The appearance of diaphragmatic adhesions is most often associated with the involvement of the pleura in the inflammatory process. Thus, pleural layers isolate the affected areas.

As a rule, mooring in the lungs does not cause painful sensations. But in some cases, there are such symptoms:

• Unproductive cough.
• Signs of respiratory failure.
• Discomfort during breathing and other painful sensations.

Such a symptom is the reason for seeking medical help and passing the diagnosis. Tissue proliferation is detected with the help of fluorography and X-ray study. If the diaphragmatic adhesions are calcified, this facilitates their detection.

In the images, the strands look like darkened sections of the pulmonary field with an intensified vascular-connective tissue pattern. With multiple lesions, diffuse dimming is determined. It is also possible to reduce the height of the standing ribs, reduce the intercostal space and the displacement of organs.

Treatment depends on the results of the diagnosis. If scar changes quickly become denser and disrupt normal lung function, then surgical intervention with a course of drug therapy is performed. The patient is also given a physiotherapy treatment. Preventive measures are of particular importance for the prevention of an adhesion disease. They consist in the timely treatment of any diseases and increase the protective properties of the immune system.

[27], [28], [29], [30], [31], [32], [33]

Basic adhesions

The enlarged connective tissue strands in the base of the lungs, that is, in the basal zone, are the basal adhesions. The formation of splices in this area is extremely rare. The main reasons for the emergence of shvarts are:

• Chronic inflammatory processes.
• Obstruction of the bronchi.
• Mechanical trauma of the respiratory system.
• Genetic and congenital diseases.
• Prolonged inhalation of dust and gases.
• Allergic alveolitis.
• Bacterial and viral diseases.

Formation of basal adhesions in the lung is possible with thrombosis of the pulmonary arteries, lack of left ventricle of the heart, violation of blood flow in the pulmonary circulation. That is, scarring of the pleura is the result of dystrophic changes. Connective tissues proliferate, deforming the structure of the organ.

The danger of a painful condition is that the spikes fill the intercellular space. Because of this, the pulmonary tissue becomes denser and the volume of ventilated air decreases, the alveolar lumens narrow. On this background can develop pneumosclerosis. The main sign of the pathological condition is respiratory failure. Without medical care, painful symptoms can progress, exacerbating discomfort. Lack of oxygen adversely affects the functioning of the entire body.

[34], [35], [36], [37], [38], [39]

Fibrous spikes in the lungs

Fibrous tissue is a type of connective tissue that replaces free space in the body. Fibrous moorings on the pleura of the lungs most often appear in such cases:

• After surgery.
• With penetrating traumatic injuries.
• After acute infectious and inflammatory processes (pneumonia, tuberculosis).

As with single, and with multiple fibrous adhesions, there are symptoms that are similar to cardiac problems:

• Pain in the chest.
• Labored breathing.
• Increased weakness and shortness of breath.
• Tachycardia.

Gradually fibrous fibrous tissues appear nerve and blood vessels. Spikes can be impregnated with calcium salts, that is, ossified. This leads to the restriction of the movements of the lungs, which disrupts their functioning. Excessive expansion of synechia is dangerous by gluing the pulmonary cavities and overgrowing them. Pathology is accompanied by severe symptoms: severe pain in breathing and acute respiratory failure. This condition requires urgent surgical treatment.

In the early stages, fibrous adhesions in the lungs do not cause painful sensations. But with the appearance of the first signs of a painful condition and a suspected adhesion, it is necessary to consult a specialist.

[40], [41], [42], [43], [44], [45]

Complications and consequences

Connective tissue growths in the lungs are dangerous serious consequences, which negatively affect the functioning of the whole organism. Pulmonary moorings can cause such complications:

• Respiratory failure.
• Oxygen starvation.
• Infection of interlobar cracks and pleural cavities.
• Thickening of pleural sheets due to multiple cicatricial changes.
• Pneumosclerosis.
• Limitation of the movement of the dome of the diaphragm.

Another rather serious complication of pulmonary adhesions is the appearance of cystic neoplasm. In the early stages of cystic fibrosis has a blurred symptomatology:

• Gradually the body temperature rises.
• Violated breathing rhythm.
• Limbs and mucous membranes acquire a cyanotic hue.
• Breathing causes severe pain and is accompanied by wheezing.

In addition to the above problems, synechia worsens the quality of life. Their appearance contributes to the development of not only pulmonary, but also heart failure. It is also possible to attach a second infection, which is fatal.

[46], [47], [48], [49], [50], [51]

Diagnostics of the adhesions in the lungs

Painful respiratory symptoms are the main reason for suspicion of adhesions in the lungs. The doctor examines the complaints of patients, collects an anamnesis and appoints a set of diagnostic measures.

Diagnostic procedures are divided into two groups: to determine the overall health of the patient and identify complications of the adhesive process. To evaluate the function of respiration, such studies are shown:

• Physical examination - examination of the chest, palpation of tissues, axillary and subclavian lymph nodes. Percussion of the thoracic cavity and auscultation with a stethophonendoscope. Also, the doctor measures the pulse, respiratory rate, body temperature and blood pressure. Based on the data obtained, a further diagnostic plan is prepared.
• Complex of laboratory studies - blood and urine analysis, gas composition of blood, bacteriological composition of sputum.
• Instrumental methods - radiography, fluorography, MRI, spirography, CT, biopsy of lung tissue.

Diagnosis is the therapist and pulmonologist. Based on the results of the analyzes, a therapy plan is drawn up.

[52], [53], [54], [55], [56]

Analyzes

Laboratory diagnostics is an obligatory component of the body's examination if suspicion of adhesions in the lungs is suspected. Analyzes are carried out not only at the stage of diagnosis, but also during the treatment.

• Blood test - if swallowing has caused respiratory insufficiency, but changes in blood composition are observed. Possible increase in leukocytes, erythrocytosis and an increase in the rate of erythrocyte sedimentation, which indicates inflammatory processes in the body. Also, there may be an increase in hemoglobin, an increase in hematocrit, eosinophilia.
• Urinalysis - allows to assess the general condition of the body and the presence of complications of connective tissue growths. In urine, cylindrical epithelial cells, protein, and erythrocytes can be detected.
• Bacteriological analysis of sputum is performed in the event that scar changes in the respiratory organs lead to acute or chronic respiratory failure. The formation of sputum with impurities of pus indicates lung damage caused by pathogenic microorganisms.

The results of the analyzes make it possible to draw up a treatment plan or to prescribe additional diagnostic studies. For example, after bacteriological tests, an antibioticogram is made to determine the sensitivity of bacteria to antibiotics and the choice of an effective drug.

[57], [58], [59], [60], [61], [62]

Instrumental diagnostics

Very often spikes in the lungs are detected during the passage of fluorography, which refers to the methods of instrumental diagnosis. This type of research is included in the mandatory for any pathological symptoms on the part of the respiratory system.

Let's consider the basic instrumental methods of revealing connective tissue growths in the lungs:

• Radiography - identifies single and multiple darkened foci that occur with pleurisy, extensive pneumonia, lung infarction. With extensive pneumosclerosis, the entire body volume is obscured. This method does not show lesions of the respiratory musculature and respiratory center.
• Spirometry - evaluation of external respiration, volume of forced expiration and peak air velocity. It allows to reveal chronic respiratory insufficiency and progressive pathological processes.
• Gas composition of blood - to carry out the analysis on the finger, the patient is put on a device with a spectrophotometric sensor. The device reads the data on the oxygen saturation of the blood and allows you to assess the degree of respiratory failure. The procedure does not cause painful sensations and has no contraindications.
• Bronchoscopy is a complex diagnostic method, in which a camera is inserted into the lumen of the bronchi. Due to this, it is possible to examine the mucous membrane of the large bronchi and trachea, and to identify the adhesions of the new ones. If there are signs of acute respiratory failure, then the study is not conducted. The procedure is performed with a preliminary anesthesia of the laryngeal mucosa.
• Electrocardiography - this method is necessary for assessing the performance of the cardiovascular system. If the adhesion occurs in a neglected form, then this has a negative effect on the state of the heart muscle. During the study, various cardiac pathologies can be identified: arrhythmia, heart attack, pulmonary heart.

The complex of the above studies allows you to make a definitive diagnosis of the presence of shvart in the pleural cavity and choose the tactics of their treatment.

Differential diagnosis

The enlarged connective tissue bands, in their symptoms, resemble not only the respiratory system disorders, but also cardiovascular pathologies, as well as violations by many other organs.

Adhesive disease is differentiated with pleurisies, pneumosclerosis, lung infarction. To identify the true disease, various diagnostic methods are used: radiography, CT and MRI of the lungs, ultrasound of the heart, general clinical analyzes. In most cases, it is the results of fluorography that make possible the final diagnosis.

Treatment of the adhesions in the lungs

The main reason for diagnosis and treatment of pulmonary shvarts are pronounced painful sensations. A therapist or a pulmonologist deals with the treatment plan. Treatment is complex and depends on the severity of the adhesions, but in most cases it is symptomatic.

Prevention

All preventive measures for adhesions in the lung tissue are reduced to the prevention of diseases of the respiratory system. For this purpose, the following activities are recommended:

• Sanitation of chronic foci of infection / inflammation in the body.
• A healthy lifestyle and a balanced diet.
• Prevention of negative effects on the body of biological, toxic and physical factors.
• Rejection of bad habits.
• The use of vitamins.
• Physical activity and hardening of the body.

There are no other options for preventing connective tissue growths. No doctor can guarantee that moorings are not formed after completely cured inflammatory or infectious pathologies. Also for the timely detection of pleural adhesions and other pathologies on the part of the respiratory organs, it is necessary to undergo fluorography every year.

[63], [64], [65], [66], [67], [68]

Forecast

The severity of the pathological process, the volume of affected tissues and the presence of complications, depends on the forecast of the shvart in the tissues of the lungs. If fibrotic changes have a focal shape, then under the condition of undergoing a doctor-appointed treatment, the patient's life is not threatened. If the spikes are multiple, then the prediction depends on the rate of development of respiratory and heart failure.

The worst prognosis is possible with such complications:

• Accession of secondary infection.
• The contraction of pleural sheets.
• Pneumosclerosis.
• Pulmonary heart.
• Oxygen starvation.
• Pulmonary hypertension.

The abovementioned consequences significantly worsen the prognosis for recovery and threaten a fatal outcome. In any case, if the patient has spasms in the lungs, and they cause painful symptoms, then every 3-4 months, a checkup is recommended by a pulmonologist. Timely diagnosis and regular preventive measures allow avoiding the development of life-threatening complications.

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