Chiang Hung-Hsing, Lee Jui-Ying, Chou Shah-Hwa, Wang Jaw-Yuan, Chang Yu-Tang
Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
J Pediatr Surg. 2009 Sep;44(9):1821-3. doi: 10.1016/j.jpedsurg.2009.04.035.
Primary spontaneous hemopneumothorax is a rare disorder but can be life-threatening secondary to massive bleeding. The authors encountered an uncommon case of left primary spontaneous hemopneumothorax and simultaneous right pneumothorax. After initial bilateral tube thoracostomies, successful 1-stage bilateral video-assisted thoracic surgery (VATS) was performed before the condition deteriorated or complications occurred. Active oozing from a ruptured vascularized bulla was identified at the apex of the left upper lobe. One-stage bilateral VATS appears to be a reasonable method of surgical intervention, but in patients under life-threatening clinical conditions, it may still be difficult to use this strategy, and a staged operation may be considered.
原发性自发性血气胸是一种罕见的疾病，但继发于大量出血时可能危及生命。作者遇到了一例罕见的左原发性自发性血气胸合并同时性右气胸的病例。在最初进行双侧胸腔闭式引流术后，在病情恶化或出现并发症之前成功进行了一期双侧电视辅助胸腔镜手术（VATS）。在左上叶尖部发现一个破裂的血管化肺大疱有活动性渗血。一期双侧VATS似乎是一种合理的手术干预方法，但对于处于危及生命临床状况的患者，使用这种策略可能仍然困难，可能需要考虑分期手术。
