Okita Riki, Miyata Yoshihiro, Hamai Yoichi, Hihara Jun, Okada Morihito
Departments of General Thoracic Surgery, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan; Department of General Thoracic Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:478-81. doi: 10.5761/atcs.cr.12-02195. Epub 2013 Nov 8.
We report a surgical case of tension pyopneumothorax in a patient who was receiving chemotherapy for esophageal cancer. A 68-year-old man who had undergone total gastrectomy with splenectomy for gastric cancer and was receiving chemotherapy for esophageal cancer was presented to our hospital with dyspnea. Left tension pyopneumothorax was diagnosed, and he received left lower lobectomy after pleural drainage. His postoperative course was uneventful, and he is alive without any cancer recurrences 5 years after the lobectomy. Once tension pyopneumothorax has developed from lung abscess, emergent lobectomy may be a useful option to prevent lethal aspiration pneumonia.
我们报告了一例正在接受食管癌化疗的患者发生张力性脓气胸的外科病例。一名68岁男性，曾因胃癌接受全胃切除术加脾切除术，目前正在接受食管癌化疗，因呼吸困难前来我院就诊。诊断为左侧张力性脓气胸，在胸腔引流后接受了左下叶切除术。他的术后病程顺利，肺叶切除术后5年仍存活，无任何癌症复发。一旦肺脓肿发展为张力性脓气胸，急诊肺叶切除术可能是预防致死性吸入性肺炎的有效选择。
