CLINICAL STUDIES ON THE ARTIFICIAL PNEUMOPERITONEUM TREATMENT OF UNEXPANDABLE LUNG

In 25 cases of unexpandable lung treated with artificial pneumoperitoneum to close the pleural dead space, clinical studies on mediastinal shift and mediastinal hernia were performed and following results were obtained: 1) Either mediastinal shift or mediastinal hernia was observed in 21 cases (81.0...

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Published inNihon Naika Gakkai Zasshi Vol. 45; no. 12; pp. 1349 - 1356
Main Author Kure, Shin-ichi
Format Journal Article
LanguageEnglish
Japanese
Published The Japanese Society of Internal Medicine 1957
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Summary:In 25 cases of unexpandable lung treated with artificial pneumoperitoneum to close the pleural dead space, clinical studies on mediastinal shift and mediastinal hernia were performed and following results were obtained: 1) Either mediastinal shift or mediastinal hernia was observed in 21 cases (81.0%), while only 4 cases (16.0%) were without both of them. 2) The longer the pleural dead space existed, the more often mediastinal shift and hernia was found. 3) In most of cases with remarkable mediastinal shift, mediastinal hernia was not or only in slight degree observed, while remarkable hernia was likely to be observed in cases without or with mediastinal shift of slight degree. 4) Mediastinal shift, which was additionally increased or newly formed by artificial pneumoperitoneum, was observed in 14 of 25 cases (56.0%). In 5 cases with mediastinal hernia the degree of hernia was increased in only one case by artificial pneumoperitoneum. 5) The dead space was closed more earlier in cases without mediastinal shift or hernia than in cases with them. In some patients among the latter the dead space failed to be closed. 6) Function of the affected lung was not improved even after the dead space had been closed. And the dysfunction of the opposite lung, which happened to occur due to expected overexpansion, was not observed in most cases. 7) The lung wss forced to be deformed and expanded in horizontal axis as the result of the collaps in apico-caudal axis due to artificial pneumoperitoneum. In this case the deformity of the lung was observed not only in the affected side with dead space, but also in the opposite side. Mediastinal shift or hernia is thought to be formed under these circumstances. These factors seems to play a great role of closing pleural dead space.
ISSN:0021-5384
1883-2083
DOI:10.2169/naika.45.1349