Author/Editor     Borovnik-Lesjak, Vesna; Prosen, Gregor; Grmec, Štefek
Title     Pnevmotoraks pri adolescentu in uporaba urgentne ultrazvočne diagnostike
Translated title     Pneumothorax in a teenager and the use of emergency ultrasound diagnostics
Type     članek
Source     In: Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja 2010. Zbornik 17. mednarodni simpozij o urgentni medicini; 2010 jun 9-12; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year     2010
Volume     str. 214-6
Language     slo
Abstract     The following paper presents a case report of a 17-year-old patient who presented to the emergency department with acute onset of dispnea. It was acompanied by onsetting hypoxemia, haemodynamic instability and normal lung sounds on auscultation. With the use of lung ultrasound a pneumothorax was diagnosed and immediately resolved with thoracocentesis which resulted in immediate relief and a rise in oxygenation. Following definite treatment of a pneumothorax and short-term hospitalization the patient was discharged. Ultrasound is becoming an increasingly important tool in emergency departments an intensive care units. Beside already well established ultrasonic diagnostics of the heart, abdomen and extremities, the sonography of the lungs and pleura is rapidly developing. Ultrasonic sign of pleural sliding can exclude a pneumothorax with 100% certainty. The ultrasound can diagnose a pneumothorax with high sensitivity (86%) and specificity (97%). The use of ultrasound in emergency medicine is also applicable in diagnosing pleural effusions, lung oedema, pneumonia, atelectasis and lung consolidations. Increasingly interesting are also ultrasonography of the optic nerve for the estimation of intracranial pressure, and of bones for diagnosing fractures.
Summary     V pričujočem sestavku opisujemo primer 17-letnega fanta, ki smo ga obravnavali v ambulanti nujne medicinske pomoči zaradi nenadnega pojava težke sape. Pri bolniku je šlo za akutno nastalo dispnejo z nastajajočo hipoksemijo, hemodinamsko prizadetostjo in ob tem avskultatorno normalnim izvidom nad pljuči. Z ultrazvokom pljuč smo v prehospitalni enoti diagnosticirali pnevmotoraks, ob takojšnji torakocentezi je prišlo do hitrega izboljšanja klinične slike in oksigenacije. Po dokončni oskrbi pnevmotoraksa in nekaj dneh hospitalnega zdravljenja je bil bolnik odpuščen v domačo oskrbo. Ultrazvok postaja vse pomembnejše orodje tudi v enotah urgentne in intenzivne medicine. Poleg že priznanih in dobro uveljavljenih področij ultrazvočne diagnostike srca, trebuha in okončin, se izredno hitro razvija tudi ultrazvok pljuč in plevre. Ultrazvočno viden znak plevralnega polzenja s 100% gotovostjo izključuje pnevmotoraks v opazovanem hemitoraksu, z UZ je možno pnevmotoraks diagnosticirati z visoko občutljivostjo (86%) in specifičnostjo (97%). Ultrazvok se v urgentni medicini uporablja tudi za diagnosticiranje plevralnih izlivov, pljučnega edema, pljučnic, atelektaz in konsolidacij pljuč. Raziskuje se tudi uporaba ultrazvoka oči oziroma vidnega živca za oceno intrakranialnega pritiska, za diagnosticiranjem zlomov kosti ter mehkih tkiv.
Descriptors     PNEUMOTHORAX
ULTRASONOGRAPHY
EMERGENCY MEDICINE