Contribution of Angiopneumography to Some Problems of Pulmonary Physiopathology

¹ Institute of Phthisiology, Medical Faculty of Montevideo, Uruguay.

A comparative angiopneumographic and bronchospirometric study was done in a group of 24 patients with definite pathological conditions of the lung, that essentially affected only one lung.

We have observed a definite relation between both methods, in the sense of a reduction of both the respiratory and circulatory functions of the abnormal lung. The following interpretation is offered: the pathological condition induces parallel changes on the circulatory and respiratory function at the same time. The phenomenon of circulatory shunt in lung pathology becomes less important than it was formerly though.

It is probable that the angiopneumographic study will take the place of the bronchospirometric study at least in the majority of cases. In practice the first named study makes more complete the information obtained by the latter; it also presents the additional advantages of making possible an appreciation of the function of the different segments of each lung.

We have also done 41 angiopneumographies on 37 patients suffering from different pathological processes of the lung, almost all of them of tuberculous origin. Based on our results we arrive at the following conclusions:

1) In ulcero-exudative tuberculosis there exists a diminution of the respiratory function, which is moderate and proportional to the extent of the process.

2) In unilateral pneumothorax, maintained by hypotension, with a clear and elastic stump, one can notice a certain diminution of the function; on the contrary the function is very much reduced or abolished in cases complicated by atelectasis of the stump or by serofibrinous or purulent pleural effusion.

3) Logically, when initial parenchymatous conditions are equal, the residual capacity of a lung, after the pneumothorax has been abandoned, is inversely proportional to the degree of the complications which might arise.

4) In pachypleuritis and in partial stenosis of a main bronchus, the respiratory function is very much reduced, much more so than could be expected through observation of ordinary plates.

5) The respiratory function disappears in fibrothorax and in cases of atelectasis.

6) Pulmonary decortication, carried out because of previous pachypleuritis, causes an improvement in the respiratory function, demonstrated by the improvement of the pulmonary circulation.