Physiological considerations.

Confirmation will be lasix without prescription asked to write this article because in the document named BЂњChronic bilateral spontaneous PneumothoraxBЂ "recently published

Joseph Lewis (1). Lewis describes the case where the clinical and x-ray findings justified the diagnosis of chronic bilateral >> << spontaneous pneumothorax. He made an exhaustive search of literature and could not find a cause. We had the honor

monitoring two such cases in the first we made a diagnosis of bilateral pneumothorax, but after more >> << experience the second case, after reviewing the physiological factors concerned and after a literature review

we came to change diagnosed as bullous emphysema. Experience Haahti (2) was particularly highlight

us in this regard. Physiological considerations. BЂ "laws of diffusion of gases in closed body cavity such that a closed pneumothorax can not exist without the

marked reduction of the affected side of the chest. If spontaneous pneumothorax occurs first, partial >> << gas pressure in the cavity of the same as in the atmosphere, but much more than the gases in the blood and tissue

. It immediately starts to gas diffusion in the pneumothorax blood, with a gradual fall in pressure >> << pneumothorax cavity. Only when the pressure falls to about 95 cm of water below atmospheric pressure

Is the balance set so that further acquisitions will not happen (3). As a result, low-pressure pneumothorax >> <<, the walls of the upper chest and compressed abdominal cavity filled up to atmospheric pressure. In the cases, said Lewis and Haahti as well as in our two cases there were no signs of reducing chest

and the pressure in the air chambers was not significantly below atmospheric. These data by themselves sufficient to exclude pneumothorax. Even open pneumothorax results in compression of the breast, if outside of the opening is larger than the glottis, which is unlikely

compatible with life. In addition, open pneumothorax invariably becomes infected and fluid develops in it. In the cases discussed >> << there were no signs of sepsis or fluid in the air chambers. The case of Lewis. BЂ "man aged in '49 was developed increasing breathlessness for 7 years and treated for asthma. There hyperresonance

in the upper lobes and vesicular breath sounds. X-type closely resembled that in our case 1. There are no easy >> << marks above the third front edge of each side, suggesting bilateral pneumothorax. However, collapsed lungs

not show in the lung roots, and they can not see the dividing line of light from the chest wall. .