Hypoplasia of the lungs is a congenital phenomenon, expressed in the underdevelopment of all structures of the respiratory system - parenchyma, blood vessels and bronchi. Pathology is often accompanied by various complications: from inflammation of the parenchyma to cystic formations in the bronchi. This condition of the lungs significantly delays the development of the child, and in severe cases leads to death.
Pulmonary hypoplasia is of two types - simple and cystic. In the first case, the pathology proceeds unnoticed and is detected only in case of infection, that is, in the process of its diagnosis and treatment. Cystic hypoplasia of the lung is manifested by characteristic signs almost immediately after birth.
Causes of hypoplasia
Pulmonary hypoplasia in children develops at the stage of embryonic development. It is known that the lungs begin to form already in the second month of pregnancy, and if at this moment there is a violation of the differentiation of the components of this organ, then as a result they are not fully formed.
There are several reasons for this pathology:
- A lung may not fully develop as a result of a large volume of fluid in it.
- The lung does not grow if it is pressed by a hernia of the diaphragm.
- Hypoplasia of the left lung in a child (as well as the right) can be the result of a curvature of his spine. In which direction he bent, then the lung and can not grow correctly, clamped by him.
- Hypoplasia of the lungs occurs with oligohydramnios caused by irregular and irregular withdrawal of urine. That is, pathology is a consequence of a malfunction of the urinary system.
- Congenital hypoplasia of the lungs can be inherited at the gene level.
- Underdeveloped blood vessels increase the likelihood of lung pathology.
Pathology classification
Hypoplasia of the lungs is divided into several types. Moreover, the classification occurs according to the degree of damage to the respiratory organ and the reasons for its appearance.
ICD-10 code for lung hypoplasia (international classification of diseases 10 revision) - Q33.0.
To understand the diversity of pathology, it is easier to display it in a list:
- Q33.1 - pathology that affects the extra lobe of the lung.
- Q33.2 - pathology, accompanied by sequestration of the lung.
- Q33.3 - lung agenesis
- Q33.4 - Congenital bronchiectasis
- Q33.5 - ectopia of lung tissue
- Q33.6 - lung dysplasia.
- Q33.9 - Atypical hypoplasia, that is, without an established cause
You should also be aware that hypoplasia of the lungs in newborns can affect one or two lungs at once. In other words, be one-sided or two-sided.
There is also a cystic form of pathology. It is characterized by the presence of cysts in the bronchi and lungs of the baby. They are single or multiple, in this case there is polycystic hypoplasia.
Symptoms of Hypoplasia
Manifestations of lung hypoplasia (according to ICD-10 code - Q33.0) depend on the form of the disease, its severity. For example, the underdevelopment of 1 or 2 segments of the lung occurs almost without any manifestations. But if a child has a lesion of 3 or more segments, then the symptoms, respectively, become noticeable. With a polycystic form, the symptoms are even more pronounced.
In a child with underdeveloped lungs, the chest is often deformed or the spine is bent. It bends to where the lung is small and underdeveloped.
Pathology is often accompanied by pain in the chest and the appearance of blood when coughing.
Underdeveloped lungs poorly supply the body with oxygen. Over time, a person develops shortness of breath, and a chronic lack of oxygen leads to acrocyanosis, and the upper phalanges on the fingers thicken.
When an infection gets into an underdeveloped lung, pneumonia develops, flowing into a chronic form.
A person with this pathology has been tormented by a hoarse cough with sputum production for almost his entire life. He feels bad all his life.
It is rare that in an organism with underdeveloped lungs, all other organs grow healthy and normal. Often hypoplasia is accompanied by such birth defects as heart disease, inguinal hernia, splitting of the sternum. The skeleton of such a person also suffers, he often has a curvature of the hands, feet and even facial bones.
Hypoplasia can not be left without treatment, because it can affect the condition of the human heart and cause severe bleeding from the lung.
Symptoms of cystic hypoplasia
The cystic form of the disease most often begins to manifest itself already at the age of 10 years and older.
A child with a cystic form of pathology has a pronounced keel-shaped chest, does not tolerate physical activity, lags behind in development, both physical and intellectual.
Clinical manifestations occur only after attaching an infection. In this case, the patient develops a cough with sputum production. Shortness of breath appears and arrhythmia is fixed.
A mild form of the disease is perceived as a cough with a small amount of sputum. This condition usually goes away after a few days. Despite the often recurring periods of coughing, the correct diagnosis is not carried out, and the patient's condition is perceived as a mild form of pneumonia. The fact that he has congenital hypoplasia of the lung (according to ICD 10 code - Q33.0) a person learns only after a deep and comprehensive diagnosis.
Diagnosis of hypoplasia
First of all, it is possible to diagnose a pathology with an external examination of the patient. After all, underdeveloped lungs lead to a curvature of the chest. It can be keeled, like a dog, can be skewed towards one underdeveloped lung. Individual rib ribs bulge or fail relative to the rest. But all this can be noticed only with a pronounced pathology. In a mild form of hypoplasia, an x-ray can help to see the curvature of the skeleton.
All displacements, blackouts and deformations are clearly visible in x-rays. Moreover, this study may reflect poorly developed vessels on the affected lung.
To determine the presence of inflammation in the lungs and bronchi, bronchoscopy is used. This method allows you to assess the degree of damage to the inflammation of the mucous membrane of the bronchi and lung segments.
And such a research technique as bronchography helps to assess the degree of development of the branches of the bronchi, their number and structure.
To determine the exact border of an underdeveloped lung parenchyma, perfusion lung scintigraphy is used.
Hypoplasia treatment
Conservative treatment is used only in a mild form of pathology, or at the very beginning, until it has led to physical changes in the body. The course of such treatment includes inhalation, rehabilitation bronchoscopy, physiotherapy.
If an underdeveloped lung is affected by an infectious disease, then it is partially or completely removed. It depends on the degree of infection and the size of the underdeveloped area. Sometimes the patient's entire left or right lung is removed.
Treatment of cystic hypoplasia
This type of pathology is treated conservatively or surgically. The treatment course for the cystic form of hypoplasia includes bronchoalveolar lavage, inhalation and postural drainage. But these methods bring only a temporary effect, alleviating the suffering of the patient. With inflammation, various antibiotics are used.
The main treatment is surgery. It is carried out in conditions where the patient is not threatened by infection or cardiovascular disease. Therefore, often before surgery, the patient is treated for inflammation with conservative methods.
During the operation, the affected part of the lung is partially removed from the patient or the whole organ.
What are the forecasts
The prognosis after this procedure is positive. Even with one light person can live a long and completely normal life. True, throughout his life he will have to carefully monitor his health, protect himself from hypothermia and the probability of contracting viruses that cause colds. Mortality after surgery is only 1-2%, that is, a child with such a pathology has all the rights to a further full life.
Prevention
Prevention of pathologies developing in utero lies entirely on the mother of the child. Underdeveloped lungs are a consequence of a woman's inattentive and frivolous attitude to pregnancy.
In order for the fetus to develop correctly and fully, the expectant mother should regularly visit a doctor and take all prescribed tests. Especially on the content of certain hormones in the blood.
She should eat a strict diet, not abuse fatty fried foods, foods with preservatives and artificial colors.
Do not drink alcohol or smoke during pregnancy.
A pregnant woman should walk at least 2 hours a day in order to improve metabolism in the pelvic organs, especially the uterus.
She needs to observe a sleep pattern and sleep at least 8 hours a day to maintain a strong nervous system.
All this must be done not only during the period of gestation, but also during pregnancy planning. That is, 1-2 months before pregnancy. And if the expectant mother has diseases of the endocrine system or some other pathologies, then it makes sense to cure them first, and only then become pregnant.