Ember Agoston, Ittzés Balázs, Heckmann Veronika, Jegesy Andrea, László Terézia, Molnár F Tamás
Pécsi Tudományegyetem, Altalános Orvostudományi Kar, Klinikai Központ Sebészeti Klinika, Pécs.
Magy Seb. 2009 Dec;62(6):350-2. doi: 10.1556/MaSeb.62.2009.6.6.
A middle-aged man presented with the diagnosis of typical spontaneous pneumothorax in the left chest. His management was initiated as usual with a chest drain and he had an uneventful recovery with good expansion of the affected lung up until the third postoperative day. But due to a fatal accident, the patient connected the oxygene supply tube into his thoracic drain. This high pressure caused a left, and a consequent bilateral pneumothorax with massive subcutanous emphysema, being the cause of a preterminal status. Cardio-pulmonary resuscitation was unsuccesfull and the patient died. Intentional suicide was excluded by forensic investigations.
According to our knowledge, no similar case with this mechanism of tension pnemuthorax has been published in the literature so far. The pathophysiology is similar to lung damage due to high-pressure ventillation with consecutive tension pneumothorax.
一名中年男性被诊断为左侧典型自发性气胸。他像往常一样接受胸腔引流治疗，术后直至第三天，患侧肺扩张良好，恢复顺利。但由于一场致命事故，患者将氧气供应管接入了胸腔引流管。这种高压导致左侧气胸，进而发展为双侧气胸并伴有大量皮下气肿，成为濒死状态的原因。心肺复苏未成功，患者死亡。法医调查排除了自杀意图。
据我们所知，迄今为止文献中尚未发表过具有这种张力性气胸机制的类似病例。其病理生理学与因高压通气导致肺损伤继而引发张力性气胸相似。
