Tanaka Kazuhisa, Suzuki Hidemi, Nakajima Takahiro, Tagawa Tetsuzo, Iwata Takekazu, Mizobuchi Teruaki, Yoshida Shigetoshi, Yoshino Ichiro
Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Surg Today. 2015 Oct;45(10):1326-9. doi: 10.1007/s00595-014-1016-z. Epub 2014 Aug 26.
We herein report a case of recurrent pneumothorax associated with congenital bronchial atresia. A 26-year-old male presented with chest pain. Chest roentgenograms showed left pneumothorax, a left apical bulla and an area of hyperlucency in the left upper lung field, and chest computed tomography revealed a discontinuation of the left superior bronchus. Additionally, both ventilation and perfusion scintigraphy showed a defect in the left superior segment. A thoracoscopy-assisted left superior segmentectomy was performed, and a pathological examination indicated left superior segmental bronchial atresia, which might have predisposed the peripheral lung to emphysematous conditions. No relapse was observed 6 months after the operation. Although this entity is rare, congenital bronchial atresia should be considered in the differential diagnosis when a patient has suffered from a recurrent spontaneous pneumothorax.
我们在此报告一例与先天性支气管闭锁相关的复发性气胸病例。一名26岁男性因胸痛就诊。胸部X线片显示左侧气胸、左肺尖部肺大疱及左上肺野透亮度增加区域,胸部计算机断层扫描显示左肺上叶支气管中断。此外,通气和灌注闪烁扫描均显示左上叶有缺损。行胸腔镜辅助下左上叶切除术,病理检查提示左上叶节段性支气管闭锁,这可能使外周肺易于发生肺气肿。术后6个月未观察到复发。尽管这种情况罕见,但当患者出现复发性自发性气胸时,鉴别诊断应考虑先天性支气管闭锁。