Linehan Laura, Hinchion John, O'Connor Terence M
Department of Respiratory Medicine, Mercy University Hospital, Cork, Ireland.
BMJ Case Rep. 2014 Mar 31;2014:bcr2014203579. doi: 10.1136/bcr-2014-203579.
A 77-year-old man with a history of pulmonary sarcoidosis was referred with persistent cough and reduced air entry on auscultation of the right lung base. He was an ex-smoker with a 40-pack-year history and his general practitioner was concerned about the possibility of bronchogenic carcinoma. A chest radiograph showed a right-sided pleural effusion with right mid-zone airspace opacification. Bronchoscopy revealed a peanut covered in mucus lodged in the right lower lobe bronchus. CT of the thorax demonstrated a multiloculated right pleural effusion with associated compressive atelectasis, consistent with chronic empyema. A chest drain was inserted but failed to fully clear the collection and the patient proceeded to a thoracoscopic decortication of a pleural empyema secondary to the right lower lobe obstruction from an inhaled peanut. His postoperative recovery was uncomplicated.
一名77岁有肺结节病病史的男性因持续咳嗽且右肺底部听诊呼吸音减弱而前来就诊。他曾吸烟，有40年的吸烟史（40包年），他的全科医生担心有支气管源性癌的可能。胸部X线片显示右侧胸腔积液伴右中带气腔模糊。支气管镜检查发现一枚被黏液包裹的花生米嵌顿在右下叶支气管内。胸部CT显示右侧多房性胸腔积液伴相关的压迫性肺不张，符合慢性脓胸表现。插入了胸腔引流管，但未能完全清除积液，随后患者接受了胸腔镜下剥除因吸入花生米导致右下叶阻塞继发的胸膜脓胸手术。他术后恢复顺利。
