Pneumatosis

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Pneumatosis
Bullous emphysema (4858473626).jpg
Left lung completely affected by bullae shown in contrast to a normal lung on the right.
Causes Tobacco smoking, pollutants

Pneumatosis is the abnormal presence of air or other gas within tissues. [1]

Contents

In the lungs, emphysema involves enlargement of the distal airspaces, [2] and is a major feature of chronic obstructive pulmonary disease (COPD). Other pneumatoses in the lungs are focal (localized) blebs and bullae, pulmonary cysts and cavities.

Pneumoperitoneum (or peritoneal emphysema) is air or gas in the abdominal cavity, and is most commonly caused by gastrointestinal perforation, often the result of surgery.

Pneumarthrosis, the presence of air in a joint, is rarely a serious sign.

Lung cysts

CT scan of lymphocytic interstitial pneumonia with pulmonary cysts. CT of lymphocytic interstitial pneumonia.jpg
CT scan of lymphocytic interstitial pneumonia with pulmonary cysts.

A lung cyst, or pulmonary cyst, encloses a small volume of air, and has a wall thickness of up to 4 mm. [3] A minimum wall thickness of 1 mm has been suggested, [3] but thin-walled pockets may be included in the definition as well. [4] Pulmonary cysts are not associated with either smoking or emphysema. [5]

A lung cavity has a wall thickness of more than 4 mm. [3]

Other thoracic

Abdominal

Low magnification micrograph of pneumatosis intestinalis in bowel wall. Pneumatosis cystoides intestinalis - low mag.jpg
Low magnification micrograph of pneumatosis intestinalis in bowel wall.

Joints

Pneumarthrosis is the presence of air in a joint. Its presentation on radiography is a radiolucent cleft often called a vacuum phenomenon, or vacuum sign. [7] Pneumarthrosis is associated with osteoarthritis and spondylosis. [8]

Pneumarthrosis is a common normal finding in shoulders [7] as well as in sternoclavicular joints. [9] It is believed to be a cause of the sounds of joint cracking. [8] It is also a common normal post-operative finding at least after spinal surgery. [10] Pneumarthrosis is extremely rare in conjunction with fluid or pus in a joint, and its presence can therefore practically exclude infection. [8]

Other

CT scan of subcutaneous emphysema. Subcutaneous emphysema abdomen arrows2.jpg
CT scan of subcutaneous emphysema.

Subcutaneous emphysema is found in the deepest layer of the skin. Emphysematous cystitis is a condition of gas in the bladder wall. On occasion this may give rise to secondary subcutaneous emphysema which has a poor prognosis. [11]

Pneumoparotitis is the presence of air in the parotid gland caused by raised air pressure in the mouth often as a result of playing wind instruments. In rare cases air may escape from the gland and give rise to subcutaneous emphysema in the face, neck, or mediastinum. [12] [13]

Terminology

The term pneumatosis has word roots of pneumat- + -osis , meaning "air problem/injury".

Related Research Articles

<span class="mw-page-title-main">Lung</span> Primary organ of the respiratory system

The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of the heart. Their function in the respiratory system is to extract oxygen from the air and transfer it into the bloodstream, and to release carbon dioxide from the bloodstream into the atmosphere, in a process of gas exchange. The pleurae, which are thin, smooth, and moist, serve to reduce friction between the lungs and chest wall during breathing, allowing for easy and effortless movements of the lungs.

<span class="mw-page-title-main">Pulmonary alveolus</span> Hollow cavity found in the lungs

A pulmonary alveolus, also known as an air sac or air space, is one of millions of hollow, distensible cup-shaped cavities in the lungs where pulmonary gas exchange takes place. Oxygen is exchanged for carbon dioxide at the blood–air barrier between the alveolar air and the pulmonary capillary. Alveoli make up the functional tissue of the mammalian lungs known as the lung parenchyma, which takes up 90 percent of the total lung volume.

<span class="mw-page-title-main">Peritonitis</span> Medical condition

Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or the entire abdomen may be tender. Complications may include shock and acute respiratory distress syndrome.

<span class="mw-page-title-main">Bronchus</span> Airway in the respiratory tract

A bronchus is a passage or airway in the lower respiratory tract that conducts air into the lungs. The first or primary bronchi to branch from the trachea at the carina are the right main bronchus and the left main bronchus. These are the widest bronchi, and enter the right lung, and the left lung at each hilum. The main bronchi branch into narrower secondary bronchi or lobar bronchi, and these branch into narrower tertiary bronchi or segmental bronchi. Further divisions of the segmental bronchi are known as 4th order, 5th order, and 6th order segmental bronchi, or grouped together as subsegmental bronchi. The bronchi, when too narrow to be supported by cartilage, are known as bronchioles. No gas exchange takes place in the bronchi.

<span class="mw-page-title-main">Atelectasis</span> Collapse or closure of a lung resulting in reduced or absent gas exchange

Atelectasis is the collapse or closure of a lung resulting in reduced or absent gas exchange. It is usually unilateral, affecting part or all of one lung. It is a condition where the alveoli are deflated down to little or no volume, as distinct from pulmonary consolidation, in which they are filled with liquid. It is often called a collapsed lung, although that term may also refer to pneumothorax.

<span class="mw-page-title-main">Mediastinum</span> Central part of the thoracic cavity

The mediastinum is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is an undelineated region that contains a group of structures within the thorax, namely the heart and its vessels, the esophagus, the trachea, the phrenic and cardiac nerves, the thoracic duct, the thymus and the lymph nodes of the central chest.

<span class="mw-page-title-main">Pulmonary sequestration</span> Medical condition

A pulmonary sequestration is a medical condition wherein a piece of tissue that ultimately develops into lung tissue is not attached to the pulmonary arterial blood supply, as is the case in normally developing lung. This sequestered tissue is therefore not connected to the normal bronchial airway architecture, and fails to function in, and contribute to, respiration of the organism.

<span class="mw-page-title-main">Esophageal rupture</span> Medical condition

Esophageal rupture is a rupture of the esophageal wall. Iatrogenic causes account for approximately 56% of esophageal perforations, usually due to medical instrumentation such as an endoscopy or paraesophageal surgery. In contrast, the term Boerhaave syndrome is reserved for the 10% of esophageal perforations which occur due to vomiting.

<span class="mw-page-title-main">Pneumoperitoneum</span> Medical condition

Pneumoperitoneum is pneumatosis in the peritoneal cavity, a potential space within the abdominal cavity. The most common cause is a perforated abdominal organ, generally from a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma. A perforated appendix seldom causes a pneumoperitoneum.

<span class="mw-page-title-main">Pneumomediastinum</span> Abnormal presence of gas in the thorax

Pneumomediastinum is pneumatosis in the mediastinum, the central part of the chest cavity. First described in 1819 by René Laennec, the condition can result from physical trauma or other situations that lead to air escaping from the lungs, airways, or bowel into the chest cavity. In underwater divers it is usually the result of pulmonary barotrauma.

<span class="mw-page-title-main">Pneumatosis intestinalis</span> Medical condition

Pneumatosis intestinalis is pneumatosis of an intestine, that is, gas cysts in the bowel wall. As a radiological sign it is highly suggestive for necrotizing enterocolitis. This is in contrast to gas in the intestinal lumen. In newborns, pneumatosis intestinalis is considered diagnostic for necrotizing enterocolitis, and the gas is produced by bacteria in the bowel wall. The pathogenesis of pneumatosis intestinalis is poorly understood and is likely multifactorial. PI itself is not a disease, but rather a clinical sign. In some cases, PI is an incidental finding, whereas in others, it portends a life-threatening intra-abdominal condition.

Hemoperitoneum is the presence of blood in the peritoneal cavity. The blood accumulates in the space between the inner lining of the abdominal wall and the internal abdominal organs. Hemoperitoneum is generally classified as a surgical emergency; in most cases, urgent laparotomy is needed to identify and control the source of the bleeding. In selected cases, careful observation may be permissible. The abdominal cavity is highly distensible and may easily hold greater than five liters of blood, or more than the entire circulating blood volume for an average-sized individual. Therefore, large-scale or rapid blood loss into the abdomen will reliably induce hemorrhagic shock and, if untreated, may rapidly lead to death.

<span class="mw-page-title-main">Pneumopericardium</span> Medical condition

Pneumopericardium is a medical condition where air enters the pericardial cavity. This condition has been recognized in preterm neonates, in which it is associated with severe lung pathology, after vigorous resuscitation, or in the presence of assisted ventilation. This is a serious complication, which if untreated may lead to cardiac tamponade and death. Pneumomediastinum, which is the presence of air in the mediastinum, may mimic and also coexist with pneumopericardium.

<span class="mw-page-title-main">Obstructive lung disease</span> Category of respiratory disease characterized by airway obstruction

Obstructive lung disease is a category of respiratory disease characterized by airway obstruction. Many obstructive diseases of the lung result from narrowing (obstruction) of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself. It is generally characterized by inflamed and easily collapsible airways, obstruction to airflow, problems exhaling, and frequent medical clinic visits and hospitalizations. Types of obstructive lung disease include; asthma, bronchiectasis, bronchitis and chronic obstructive pulmonary disease (COPD). Although COPD shares similar characteristics with all other obstructive lung diseases, such as the signs of coughing and wheezing, they are distinct conditions in terms of disease onset, frequency of symptoms, and reversibility of airway obstruction. Cystic fibrosis is also sometimes included in obstructive pulmonary disease.

<span class="mw-page-title-main">Subcutaneous emphysema</span> Medical condition

Subcutaneous emphysema occurs when gas or air accumulates and seeps under the skin, where normally no gas should be present. Subcutaneous refers to the subcutaneous tissue, and emphysema refers to trapped air pockets. Since the air generally comes from the chest cavity, subcutaneous emphysema usually occurs around the upper torso, such as on the chest, neck, face, axillae and arms, where it is able to travel with little resistance along the loose connective tissue within the superficial fascia. Subcutaneous emphysema has a characteristic crackling-feel to the touch, a sensation that has been described as similar to touching warm Rice Krispies. This sensation of air under the skin is known as subcutaneous crepitation, a form of crepitus.

<span class="mw-page-title-main">Emphysematous cystitis</span> Medical condition

Emphysematous cystitis is a rare type of infection of the bladder wall by gas-forming bacteria or fungi. The most frequent offending organism is E. coli. Other gram negative bacteria, including Klebsiella and Proteus are also commonly isolated. Fungi, such as Candida, have also been reported as causative organisms. Citrobacter and Enterococci have also been found to cause emphysematous cystitis. Although it is a rare type of bladder infection, it is the most common type of all gas-forming bladder infections. The condition is characterized by the formation of air bubbles in and around the bladder wall. The gas found in the bladder consists of nitrogen, hydrogen, oxygen, and carbon dioxide. The disease most commonly affects elderly diabetic and immunocompromised patients. The first case was identified in a post-mortem examination in 1888.

<span class="mw-page-title-main">Pulmonary pleurae</span> Serous membrane that lines the wall of the thoracic cavity and the surface of the lung

The pulmonary pleurae are the two opposing layers of serous membrane overlying the lungs and the inside of the surrounding chest walls.

<span class="mw-page-title-main">Emphysema</span> Medical condition

Emphysema is any air-filled enlargement in the body's tissues. Most commonly emphysema refers to the enlargement of air spaces (alveoli) in the lungs, and is also known as pulmonary emphysema.

<span class="mw-page-title-main">Lung cavity</span> Medical condition

A lung cavity or pulmonary cavity is an abnormal, thick-walled, air-filled space within the lung. Cavities in the lung can be caused by infections, cancer, autoimmune conditions, trauma, congenital defects, or pulmonary embolism. The most common cause of a single lung cavity is lung cancer. Bacterial, mycobacterial, and fungal infections are common causes of lung cavities. Globally, tuberculosis is likely the most common infectious cause of lung cavities. Less commonly, parasitic infections can cause cavities. Viral infections almost never cause cavities. The terms cavity and cyst are frequently used interchangeably; however, a cavity is thick walled, while a cyst is thin walled. The distinction is important because cystic lesions are unlikely to be cancer, while cavitary lesions are often caused by cancer.

<span class="mw-page-title-main">Focal lung pneumatosis</span> Medical condition

A focal lung pneumatosis, is an enclosed pocket of air or gas in the lung and includes blebs, bullae, pulmonary cysts, and lung cavities. Blebs and bullae can be classified by their wall thickness.

References

  1. "Medical Definition of PNEUMATOSIS". www.merriam-webster.com. Retrieved 31 July 2021.
  2. page 64 in: Adrian Shifren (2006). The Washington Manual Pulmonary Medicine Subspecialty Consult, Washington manual subspecialty consult series. Lippincott Williams & Wilkins. ISBN   9780781743761.
  3. 1 2 3 Dr Daniel J Bell and Dr Yuranga Weerakkody. "Pulmonary cyst". Radiopaedia . Retrieved 2019-05-01.
  4. Araki, Tetsuro; Nishino, Mizuki; Gao, Wei; Dupuis, Josée; Putman, Rachel K; Washko, George R; Hunninghake, Gary M; O'Connor, George T; Hatabu, Hiroto (2015). "Pulmonary cysts identified on chest CT: are they part of aging change or of clinical significance?". Thorax. 70 (12): 1156–1162. doi:10.1136/thoraxjnl-2015-207653. ISSN   0040-6376. PMC   4848007 . PMID   26514407.
  5. Araki, Tetsuo. "Pulmonary cysts identified on chest CT:are they part of ageing change or of clinical significance" (PDF). Retrieved 19 January 2019.
  6. "Gastric emphysema | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Retrieved 28 June 2019.
  7. 1 2 Abhijit Datir; et al. "Vacuum phenomenon in shoulder". Radiopaedia . Retrieved 2018-01-03.
  8. 1 2 3 Page 60 in: Harry Griffiths (2008). Musculoskeletal Radiology. CRC Press. ISBN   9781420020663.
  9. Restrepo, Carlos S.; Martinez, Santiago; Lemos, Diego F.; Washington, Lacey; McAdams, H. Page; Vargas, Daniel; Lemos, Julio A.; Carrillo, Jorge A.; Diethelm, Lisa (2009). "Imaging Appearances of the Sternum and Sternoclavicular Joints". RadioGraphics. 29 (3): 839–859. doi:10.1148/rg.293055136. ISSN   0271-5333. PMID   19448119.
  10. Mall, J C; Kaiser, J A (1987). "The usual appearance of the postoperative lumbar spine". RadioGraphics. 7 (2): 245–269. doi:10.1148/radiographics.7.2.3448634. ISSN   0271-5333. PMID   3448634.
  11. Sadek AR, Blake H, Mehta A (June 2011). "Emphysematous cystitis with clinical subcutaneous emphysema". International Journal of Emergency Medicine. 4 (1): 26. doi:10.1186/1865-1380-4-26. PMC   3123544 . PMID   21668949.
  12. McCormick, Michael E.; Bawa, Gurneet; Shah, Rahul K. (2013). "Idiopathic recurrent pneumoparotitis". American Journal of Otolaryngology. 34 (2): 180–182. doi:10.1016/j.amjoto.2012.11.005. ISSN   0196-0709. PMID   23318047.
  13. Joiner MC; van der Kogel A (15 June 2016). Basic Clinical Radiobiology, Fifth Edition. CRC Press. p. 1908. ISBN   978-0-340-80893-1.