Hydropneumothorax

Seropneumothorax
rechts: Unterlappen und Mittellappen scheinen im Pleuraerguss. Die Lungenspitze liegt dem thorakalen Apex nicht an.
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Seropneumothorax
nach Rippenfrakturen sekundär aufgetreten. Basaler Spiegel.
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Teenager in a
motor vehicle accident with chest painCXR AP shows a widened mediastinum and a small right-sided pneumothorax. Axial CT with contrast of the chest with lung (above) and bone (below) windows shows air in the pleural space anterior to the right lung and fluid in the pleural space posterior to the right lung as well as airspace disease in the right lower lobe and a cortical disruption through one of the right ribs posteriorly.The diagnosis was a right hydropneumothorax, right pulmonary contusion, and right posterior rib fracture. Angiogram was negative for aortic injury.
pediatricimaging.org • CC-by-nc-sa 4.0
Hydropneumothorax
• Hydropneumothorax, pneumomediastinum, pneumoperitoneum and pneumoretroperitoneum - Ganzer Fall bei Radiopaedia
Qureshi P, Hydropneumothorax, pneumomediastinum, pneumoperitoneum and pneumoretroperitoneum. Case study, Radiopaedia.org (Accessed on 04 Dec 2022) https://doi.org/10.53347/rID-68101 • CC by-nc-sa 3.0 (modified)
Radiopaedia • CC-by-nc-sa 3.0 • de

A hydropneumothorax (plural: hydropneumothoraces) (or less commonly pneumohydrothorax (plural: pneumohydrothoraces)) is the term given to the concurrent presence of a pneumothorax and pleural effusion (i.e. hydrothorax) (i.e. gas and fluid) in the pleural space.

Pathology

It may arise in various situations which include

Radiographic features

Plain radiograph

On an erect chest radiograph, recognition of hydropneumothorax can be rather easy - and is classically shown as a gas-fluid level. On the supine radiograph, this may be more challenging where a sharp pleural line is bordered by increased opacity lateral to it within the pleural space may sometimes suggest towards the diagnosis .

Ultrasound

Sonographic findings include ;

  • hydro-point sign
    • describes the interface of a pleural line which lacks lung sliding and an anechoic collection bounded inferiorly by the diaphragm
      • coexistence of the sonographic signs characteristic of a pneumothorax and a pleural effusion 
    • a lung point sign may also be found

Differential diagnosis

For a gas-fluid level on plain radiograph consider:

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Seropneumothorax:
Pleuraerguss
 
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Pleuraempyem
 
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