Gangrene lung: causes, symptoms, diagnosis, treatment

Gangrene of the lungs is a serious pathological condition, characterized by extensive necrosis and ichorous decomposition of the affected lung tissue, not prone to clear delimitation and rapid purulent fusion.

Symptoms of gangrene of the lungs

1. The general severe condition of the patient: the body temperature is hectic, chills, severe intoxication, weight loss, lack of appetite, dyspnea, tachycardia.
2. Pain in the chest on the side of the lesion, aggravated by coughing.
3. When percussion over the affected area, dull sound and soreness (Kryukov-Sauerbruch symptom), with a stethoscope pressing on the intercostal space, cough appears in this area (Kissling's symptom). With the rapid disintegration of necrotic tissue, the blunting zone increases, and areas of higher sound appear on its background.
4. At auscultation, breathing over the affected area is weakened or bronchial.
5. After the breakthrough, a cough appears in the bronchus with a foul smelling discharge of dirty gray in large quantities (up to 1 liter or more), wet rales are heard over the lesion. The course of gangrene of the lung is always heavy. Complications often develop, which can lead to death.

Laboratory data

1. General blood test: signs of anemia, leukocytosis, stab shift, toxic granularity of neutrophils, marked increase in ESR.
2. General urine analysis: proteinuria, cylinduria.
3. Biochemical analysis of blood: increase in the content of sialic acids, fibrin, seromucoid, haptoglobin, alpha2- and gamma globulins, transaminase, decrease in albumin content.
4. General analysis of sputum: the color is dirty gray, when settling, three layers are formed: the upper layer is liquid, frothy, whitish, the middle - serous, the lower one - consisting of purulent detritus and scraps of melting pulmonary tissue; Elastic fibers are identified, many neutrophils.

Instrumental research

X-ray examination: before the breakthrough in the bronchus - massive infiltration without clear boundaries, occupying one to two lobes, and sometimes all the lungs; after a breakthrough in the bronchus against a background of massive darkening, multiple, more often small enlightenments of irregular shape, sometimes with liquid levels, are determined.

The program for examination with gangrene of the lungs

1. General tests of urine, blood.
2. Biochemical blood test: total protein, protein fractions, transaminases, aldolase, bilirubin, urea, seromucoid, fibrin, haptoglobin, sialic acids.
3. General clinical examination of sputum: general, elastic fibers, atypical cells, BC.
4. Bronchoscopy with sputum examination on flora and sensitivity to antibiotics.
5. ECG.
6. X-ray and radiography of the lungs.
7. Fibrobronchoscopy.

[1], [2], [3], [4], [5], [6]