№ 35Thematic Questions18 min read
Diseases of the thoracic wall and pleura, and their treatment
1. Big picture
Diseases of the thoracic wall and pleura are surgically important because they can cause:
- Respiratory compromise
- Pleural space infection
- Lung collapse
- Massive intrathoracic bleeding
- Chronic trapped lung
- Chest wall deformity
- Malignant pleural disease
- Chest wall instability or tumor invasion
For the surgery exam, the key decision is:
Is this an emergency pleural problem, a chronic pleural disease, or a chest wall structural/tumor problem?
The most important emergency diagnoses are:
- Tension pneumothorax
- Massive hemothorax
- Empyema with sepsis
- Flail chest with respiratory failure
- Large pleural effusion causing respiratory distress
2. Surgical anatomy
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