Hemopneumothorax Definition, Symptms, Causes, Treatment

When a fracture of the rib breaks through the lungs, the blood of the affected lung also accumulates in the pleural space this is called hemopneumothorax because the pleural space contains both blood and air. The amount of blood that accumulates in the pleural space depends on the size and extent of lung damage. In some cases, the accumulation of blood is minimal in other cases, it is significant. As blood and air continue to accumulate in the pleural space, the pressure on the lungs shrinks through the mediastinum to the healthy lung.

A pneumothorax is a hemopneumothorax with bleeding in the pleural space. This is usually due to a penetrating trauma, such as a shot or a knife. Initial trauma allows air to enter pleural space and create pneumothorax. Bleeding caused by trauma allows the blood to collect in the pleural space with air, creating hemopneumothorax.

Bleeding may originate from damaged blood vessels, pulmonary bruising, or even rapid deceleration. History and physical results of hemopneumothorax are similar to hemothorax, including dyspnoea, tachypnea and tachycardia. Patients can also obviously represent chest trauma, possibly hypotension and shock. Physical exploration can reveal possible segments of ulcers, subcutaneous emphysema or hematoma. Lung exudation reveals reduced or absent breathing sounds of affected lungs and hyperresonance on percussion.

Hemopneumothorax Definition, Symptms, Causes, Treatment


Hemopneumothorax Symtoms


Some commonly reported symptoms of pneumothorax are given below


  • Chest Pain
  • Shortness of breath
  • Tachypnea
  • Tachycardia
  • Hypoxia
  • Decreased breath sounds
  • Subcutaneous Emphysema
  • Palipitation
  • Feeling of Heavy chest


Hemopneumothorax Causes

Exact underlying cause of hemopneumothorax can only be done via radiological findings. However, some injuries that have strong correlation with hemopneumothorax are blunt chest taruma, penetrating chest injury, fractured ribs and aspiration of hemothorax. Important radiological findings during scanning are obliteration of costophrenic angle, fluid level with air shadow above, collapsed lung border.

Hemopneumothorax Treatment

Treatment of hemopneumothorax mainly depends on invasive procedure. Patient having severe form of hemopenumothorax should be decompressed via chest tube before starting any procedure. In case of tension penumothorax emergent needle decompression with large gauge needle placed in the second intercostal space at midclavicular line. To minimize chances of infection you health care provider may prescribe you antibiotics as well. 

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Enthesophyte ICD-10, Treatment, Symptoms, Causes

Enthesophyte, can be defined as abnormal development of bony prominence at the end of the normal bone contour, that can be observed in two perpendicular planes, either with acoustic shadow or with out it.

Enthesophyte formation is a new bone to the site of attaching tendons, ligaments or the capsule of the joint. Enthesophyte reflects the response of bone to stress applied through these structures such as ligamentous or capsular tearing. Enthesophyte formations take several weeks to months to develop and may or may not be associated with clinical signs. Indentifying tendons, ligaments and capsule insertions is essential to determine which structure of soft tissues may be damaged. In some places, such as the hock, the differentiation between enthesophyte formation and osteophytes is not easy.

Development of enthesophyte is a new bone at the site of ligament or tendon. Newborn Entheseous bones reflect the response to stress applied through the following structures, such as tear connections or capsular tension. Like osteophytes, enthesophytes development take several weeks to months and may or may not be associated with clinical signs.

Knowing the anatomy of ligamnet, tendons and capsule insertions is essential to determine which structure of soft tissues may have been damaged. In some places, such as the hock joint, the distinction between entesophyte development and osteophytes is not easy. Cranialis tibialis, dorsal tarsal ligament and fibularis tertius are close to the general boundary of tarsometatarsal joint and the differentiation between new bone and bony prominence of osteophyte can be difficult.

Enthesophyte ICD-10, Treatment, Symptoms, Causes


Enthesophyte Symptoms


Some commonly reported symptoms of enthesophyte are given below


  • Problem in joint mobility
  • Narrowing of joint space
  • Swelling
  • Deep and intense pain
  • Joint stiffness
  • Feeling of grating
  • Bone spur

Enthesophyte Causes


Though exact mechanism by which enthesophytes are formed is not fully understood. However, many orthopedic surgeons believe that putting excessive stress over bony structure may cause abnormalities in normal bone development in the form of enthesophytes. Some other diseases that have strong correlation with enthesophytes are tennis elbow, postman's heel, plantar fasciitis, golfers elbow and spondylitis.

Enthesophyte Treatment

Treatment mainly depends upon severity of symptoms. If patient feels only mild to moderate pain then pain killers are mainstay for such problem. Most commonly used pain killers are diclofenac sodium and naproxen sodium. If patient feels intense pain along swelling around affected area and mobility of joint is compromised then surgery would be preferred because at this stage medicines may become useless to decrease the severity of symptoms.

Enthesophyte ICD-10

Following code is used for Enthesophyte in ICD-10

M77.9--Enthesopathy, unspecified--Billable.

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