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一名因肺炎接受治疗的儿童出现血性心包填塞,最初被误诊为肺部肿瘤并伴有心脏浸润。

Bloody pericardial tamponade in a child treated for pneumonia mimicking a lung tumor and infiltration of the heart.

作者信息

Haponiuk Ireneusz, Chojnicki Maciej, Jaworski Radoslaw, Zielinski Jacek, Irga-Jaworska Ninela, Gierat-Haponiuk Katarzyna, Sroka Mariusz

机构信息

Department of Pediatric Cardiac Surgery, Mikołaj Kopernik Pomeranian Centre of Traumatology, Gdansk, Poland.

出版信息

Contemp Oncol (Pozn). 2013;17(2):225-7. doi: 10.5114/wo.2013.34630. Epub 2013 Apr 29.

DOI:10.5114/wo.2013.34630
PMID:23788997
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3685359/
Abstract

We present the dramatic course of a female 5-year-old child with pneumonia and symptoms similar to local compression of the pericardium by a tumorous mass originating from the left lung. The child was treated with antibiotics for pneumonia with bilateral pleural effusions that required chest drainage. On the 10(th) day of therapy there was sudden anemia observed with the echocardiographic finding of acute cardiac tamponade. The child was referred for emergency life-saving surgical intervention. The chest was opened via a minimally invasive mini-incision in the area of the xiphoid process and bloody tension pericardial effusion was evacuated. The laboratory and histopathology investigations were not specific for neoplastic disease or tuberculosis infection. In the further observation the girl recovered and was discharged home two weeks after tamponade drainage. Fortunately our initial suspicion of neoplastic disease was not proved; nevertheless we would like to emphasize the need for oncologic vigilance in similar cases.

摘要

我们报告了一名5岁女童的戏剧性病程,她患有肺炎,症状类似于左肺肿瘤性肿块对心包的局部压迫。该患儿因双侧胸腔积液的肺炎接受抗生素治疗,胸腔积液需要胸腔引流。在治疗的第10天,突然出现贫血,超声心动图检查发现急性心脏压塞。患儿被转诊进行紧急救生手术干预。通过剑突下区域的微创小切口打开胸腔,排出了血性张力性心包积液。实验室和组织病理学检查对肿瘤性疾病或结核感染均无特异性。在进一步观察中,女孩康复,心包积液引流两周后出院回家。幸运的是,我们最初对肿瘤性疾病的怀疑未得到证实;尽管如此,我们仍想强调在类似病例中保持肿瘤学警惕的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19df/3685359/d4646298dd90/WO-17-20642-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19df/3685359/eb7255d3b5e0/WO-17-20642-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19df/3685359/6d6ca626d73d/WO-17-20642-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19df/3685359/d4646298dd90/WO-17-20642-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19df/3685359/eb7255d3b5e0/WO-17-20642-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19df/3685359/6d6ca626d73d/WO-17-20642-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19df/3685359/d4646298dd90/WO-17-20642-g003.jpg

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Teratomas of the neck and mediastinum in children.儿童颈部和纵隔畸胎瘤
Pediatr Surg Int. 2006 Aug;22(8):627-34. doi: 10.1007/s00383-006-1724-6. Epub 2006 Jul 13.
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The anterior mediastinum: diseases.前纵隔:疾病
Radiol Med. 2006 Apr;111(3):312-42. doi: 10.1007/s11547-006-0032-5. Epub 2006 Apr 11.
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Teratoma occupying the left hemithorax.畸胎瘤占据左半胸。
World J Surg Oncol. 2005 Nov 22;3:76. doi: 10.1186/1477-7819-3-76.
5
Median sternotomy provides excellent exposure for excising anterior mediastinal tumors in children.正中胸骨切开术为切除儿童前纵隔肿瘤提供了极佳的视野。
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Pericardial tamponade and large pericardial effusions: causal factors and efficacy of percutaneous catheter drainage in 50 patients.心包填塞与大量心包积液:50例患者的病因及经皮导管引流的疗效
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