Paraplegic

Paraplegic is an inflammation of the tissue, located between the parietal pleura and intrathoracic fascia. Usually paraplegic tubercular etiology; can also occur after injury. Is sometimes possible to reveal certain limited by the swelling of the chest wall (with a puncture get pus), sometimes long-term healing fistula.
Treatment of parapleuritis - surgical.

Paraplegic (parapleuritis; from the Greek. para - about + pleurisy; synonymous with pereplavit) - inflammation of the tissue, located between the parietal pleura and intrathoracic fascia.
There are paraplegic specific (tuberculosis), and non-traumatic. When specific and nonspecific parapleuritis source of inflammation are paraphanalia lymph nodes, in which the infection gets hematogenous or lymphogenous way. With traumatic P. infection in parallelno fiber is made offensive shell. The vast majority P. has specific character.
Parapleuritis divided well as primary and secondary. In primary P. inflammation pereplavleni fiber occurs as a result of specific inflammation pereplavleni lymph node tuberculosis of the lung or pleura. Secondary P. is a consequence of the transition of the inflammatory process with bones (ribs) on parallelno tissue.
Primary specific paraplegic occurs most often as a chronic inflammatory process. Initially affects only the lymph nodes (typical lymphadenitis). Then as cheesy rebirth of the lymph nodes and involvement in the process pereplavleni tissue infiltration occurs, which, as a rule, suppurate. However, the abscess is never revealed in the pleural cavity, as contiguous parietal pleura quickly reactive thickens with the formation of adhesions. So ulcer can only push this thickness in the pleura. With the accumulation of pus ulcer penetrates under the intercostal muscles bulging intercostal space, then in the subcutaneous tissue and, finally, opened out with the formation of fistulas.
Diagnosis can be based on the following characteristics (D. G. Iosseliani): infiltration is limited to one-two intercostal space; palpation no sharp pain; when inhaling voltage infiltration increases; stupidity with percussion limited area of infiltration, the disease is chronic; no pronounced temperature reaction and characteristic for inflammation of the blood picture; when fluoroscopy the pleural cavity free, intrathoracic organs are not displaced; at the side of the x-ray revealed a thick parietal pleura, the defeat of the ribs are missing; at the puncture of the abscess will receive characteristic of tuberculosis pus, sowing which the growth of microorganisms does not.
Conservative treatment of parapleuritis can be effective only in the stage of infiltration. After the formation of the abscess showing surgery. Puncture gives only temporary remission.
Surgical treatment: most surgeons recommend a complete excision of the ulcer with suturing wounds; some - wide opening the abscess. E. C. Drachinsky recommends that the excision of ulcer with muscle plastics; this method gives the best results.