Unlüer Erden Erol, Karagöz Arif
Emergency Department, İzmir Katip Çelebi University Atatürk Research and Training Hospital İzmir Turkey.
Interv Med Appl Sci. 2014 Mar;6(1):40-2. doi: 10.1556/IMAS.6.2014.1.6. Epub 2014 Mar 14.
Acute dyspnoea is one of the most common reasons patients present to the emergency department (ED). In most cases, the physical examination and bedside radiographs are inconclusive, resulting in the need for more sophisticated diagnostics. These diagnostics may delay treatment or expose the patient to unnecessary radiation. Here, we present the case of a dyspnoeic patient. The patient was diagnosed with pneumonia by bedside thoracic ultrasonography (TUS). TUS was performed by the emergency physician and revealed bilateral pleural effusion, which was more significant on the right side of the thorax. The right lower lung lobe was consolidated, and dynamic air bronchograms were present on TUS. Computerised tomography of the chest was ordered. Bilateral multilobar consolidations were clearly appreciated with bilateral pleural effusion. Because of the dynamic nature of the disease process, we were able to diagnose pathological changes in the lung. In conclusion, TUS may be used for diagnosing pneumonia in the ED because it has high accuracy, low cost and no radiation exposure. Furthermore, it can be used bedside, and there is no need to transport an emergent patient to the radiology unit.
急性呼吸困难是患者前往急诊科就诊的最常见原因之一。在大多数情况下，体格检查和床边X光片结果不明确，因此需要更复杂的诊断方法。这些诊断方法可能会延误治疗或使患者受到不必要的辐射。在此，我们介绍一例呼吸困难患者的病例。该患者通过床边胸部超声检查（TUS）被诊断为肺炎。TUS由急诊医生进行，显示双侧胸腔积液，右侧胸腔更为明显。右下肺叶实变，TUS上可见动态空气支气管征。随后安排了胸部计算机断层扫描。可见双侧多叶实变并伴有双侧胸腔积液。由于疾病过程的动态性质，我们能够诊断出肺部的病理变化。总之，TUS可用于急诊科肺炎的诊断，因为它具有高准确性、低成本且无辐射暴露。此外，它可在床边使用，无需将急诊患者转运至放射科。
