Marinho Anabela, Lima Beatriz, Araújo Idalina, Bastos Pedro, Marques J Agostinho, Gomes Isabel
Interna Complementar de Pneumologia do Hospital de S. João, 4202-451 Porto, Portugal.
Rev Port Pneumol. 2007 Jul-Aug;13(4):613-7.
Spontaneous contralateral pneumothorax after pneumonectomy is a rare condition. A high index of suspicion is required for a correct diagnosis. Management can be challenging, as surgical intervention, if necessary, is a very high risk procedure. Chemical pleurodesis can be a simple and effective measure in cases with no major air leak. We describe the case of a 21-year-old female with spontaneous pneumothorax in a single lung, which posed several diagnostic and therapeutic problems. The presence of a "buffalo chest" made the initial chest x-ray interpretation difficult. The patient had an important air leak without complete pulmonary expansion and thoracic surgery was considered of risk. Accordingly, instillation of talc slurry through one of the thoracic drains was undertaken with eventual resolution. We are convinced that bronchopleural fistula resolution was facilitated by slurry talc, despite complete lung expansion never having been achieved.
肺切除术后自发性对侧气胸是一种罕见的病症。正确诊断需要高度的怀疑指数。由于必要时手术干预是一项风险极高的操作，因此治疗可能具有挑战性。对于无大量漏气的病例，化学性胸膜固定术可能是一种简单有效的措施。我们描述了一名21岁单肺自发性气胸女性的病例，该病例存在多个诊断和治疗问题。“水牛胸”的存在使得最初的胸部X光片解读困难。患者存在严重漏气且肺未完全复张，胸外科手术被认为具有风险。因此，通过一根胸腔引流管注入滑石粉悬液，最终病情得到缓解。我们确信，尽管肺从未完全复张，但滑石粉悬液促进了支气管胸膜瘘的愈合。
