Niimi Takao, Gotoh Mio
Department of General Thoracic Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan.
Kyobu Geka. 2010 Apr;63(4):324-7.
We present a rare case of pneumothorax due to the perforation of bullae associated with congenital bronchial atresia. A 25-year-old woman complained of right chest pain and shortness of breath. Chest radiography revealed a right pneumothorax. Chest tube drainage was performed. When the lung re-expanded, chest computed tomography (CT) showed blind-ending B4 of the right middle lobe associated with mucoid impaction and hyperlucency of the corresponding lung parenchyma. Additionally, there were multiple air cysts located at the affected lung surface. A surgical procedure was considered because of persistent air leaks. At operation, several bullae projected above the pleural surface of the hyperinflated S4, and one of the bullae ruptured. A lateral segmentectomy of the middle lobe was successfully performed by thoracoscopy-assisted limited thoracotomy. Diagnosis of congenital bronchial atresia and subpleural bullae was confirmed by pathological examination.
我们报告一例罕见的因先天性支气管闭锁相关大疱穿孔导致的气胸病例。一名25岁女性主诉右胸痛和呼吸急促。胸部X线检查显示右侧气胸。进行了胸腔闭式引流。当肺复张时,胸部计算机断层扫描(CT)显示右中叶B4呈盲端,伴有黏液嵌塞及相应肺实质透亮度增加。此外,在患侧肺表面有多个气囊。由于持续漏气,考虑进行外科手术。手术中,几个大疱突出于过度膨胀的S4胸膜表面之上,其中一个大疱破裂。通过电视胸腔镜辅助下有限开胸成功实施了右中叶外侧段切除术。病理检查证实为先天性支气管闭锁和胸膜下大疱。