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修复曲霉菌感染导致的气管穿孔合并张力性气胸

Repair of tracheal aspergillosis perforation causing tension pneumothorax.

机构信息

Division of Thoracic Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

出版信息

Ann Thorac Surg. 2013 Dec;96(6):2256-8. doi: 10.1016/j.athoracsur.2013.06.064.

Abstract

Tracheobronchial aspergillosis is a rare entity mainly observed in immune-compromised patients or those who have undergone transplantation. It may cause airway ulcerations or bleeding. We report the case of a 17-year-old patient receiving chemotherapy for acute lymphoblastic leukemia who presented with right-sided tension pneumothorax. Chest tube drainage revealed a massive air leak without reexpansion of the lung, and bronchoscopy showed a 15- × 15-mm defect of the distal trachea related to aspergillosis infection. The defect was closed by an intrathoracic transposition of a pedicled latissimus dorsi muscle flap, which was sutured into the debrided defect followed by temporary endotracheal stenting and antifungal medication.

摘要

气管支气管曲霉病是一种罕见的疾病,主要发生于免疫功能低下的患者或接受过移植的患者。它可能导致气道溃疡或出血。我们报告了一例 17 岁的急性淋巴细胞白血病化疗患者,该患者出现右侧张力性气胸。胸腔引流管显示大量漏气,而肺部未复张,支气管镜检查显示远端气管有 15×15 毫米的与曲霉病感染相关的缺损。通过经胸廓内转移带蒂背阔肌皮瓣来封闭缺损,将皮瓣缝合到清创后的缺损处,然后进行临时气管内支架和抗真菌治疗。

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