Tanaka Hisaichi, Matsumura Akihide, Iuchi Keiji
Department of Surgery, National Hospital Organization, Kinki-Chuo Chest Medical Center, Sakai, Osaka, Japan.
Surg Today. 2006;36(7):586-9. doi: 10.1007/s00595-006-3216-7.
The development of a chronic expanding hematoma after paraffin plombage has not yet been reported because the procedure was performed only at a limited number of institutes during the short period before the development of antituberculous drugs. We herein report eight patients with chronic expanding hematoma several decades after undergoing extraperiosteal paraffin plombage.
We reviewed eight surgically treated patients with chronic expanding hematoma after undergoing extraperiosteal paraffin plombage.
Swelling of the plombage space was shown in a chest roentgenogarm and a contrast-enhanced computed tomographic scan as an expanding inhomogeneous mass with subcapsular enhancements. The patient symptoms included a chest or axillary tumor in three patients, and shoulder pain in two, while three were asymptomatic prior to radiological evidence of disease progression. No tuberculous bacillus was detected on microbacterial examination. Both the paraffin and hematomas were removed. The average operative bleeding was 161 ml. One patient underwent muscle transposition for postoperative infection of the residual space. Following the operation, seven patients remained free from the disease and one had hematoma recurrence 9 years later, which was again removed.
A chronic expanding hematoma following extraperiosteal paraffin plombage is a rare complication. However, this disease should be considered when a patient who has undergone paraffin plombage presents with late complications.
由于在抗结核药物出现之前的短时间内,仅在少数机构进行了石蜡填充术,因此尚未有关于石蜡填充术后慢性进行性血肿发生情况的报道。我们在此报告8例在接受骨膜外石蜡填充术后数十年出现慢性进行性血肿的患者。
我们回顾性分析了8例接受手术治疗的骨膜外石蜡填充术后慢性进行性血肿患者。
胸部X线片和增强CT扫描显示填充腔肿胀,表现为一个进行性增大的不均匀肿块,有包膜下强化。患者症状包括3例出现胸部或腋窝肿物,2例出现肩部疼痛,而3例在影像学显示疾病进展之前无症状。微生物检查未检测到结核杆菌。石蜡和血肿均被清除。术中平均出血量为161毫升。1例患者因残余腔术后感染接受了肌肉转位术。术后,7例患者未再发病,1例在9年后血肿复发,再次接受了清除手术。
骨膜外石蜡填充术后慢性进行性血肿是一种罕见的并发症。然而,当接受过石蜡填充术的患者出现晚期并发症时,应考虑到这种疾病。