Aguir S, Boddaert G, Weber G, Hornez E, Pons F
Service de chirurgie thoracique et vasculaire, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France.
Service de chirurgie thoracique et vasculaire, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France.
Rev Pneumol Clin. 2015 Feb;71(1):60-3. doi: 10.1016/j.pneumo.2014.11.005. Epub 2015 Feb 14.
Lung hernias are rare and their pathogenesis is few described. They are defined as the protrusion of lung parenchyma through the chest wall: intercostal space, inter-costo-clavicular, supra-clavicular or diaphragmatic hiatus. Lung hernias are classically divided into congenital and acquired hernias. Those are usually post-traumatic or post-surgical but can be provoked by cough. Clinical diagnosis is often evident but is confirmed by chest radiograph and especially computed tomography. Major risks are lung incarceration and necrosis but also ventilatory distress due to paradoxical respiration, in case of large defect. Treatment is first and foremost surgical but debated and should consider the localization, the size, the length of evolution and the possible infectious context. We report the case of a right basi-thoracic lung hernia induced by a cough fit, in a patient with chronic bronchitis.
肺疝较为罕见,其发病机制鲜有描述。肺疝被定义为肺实质通过胸壁突出:肋间间隙、肋锁间、锁骨上或膈肌裂孔。肺疝传统上分为先天性和后天性疝。后天性肺疝通常为创伤后或手术后形成,但也可由咳嗽诱发。临床诊断通常较为明显,但需通过胸部X光片尤其是计算机断层扫描来确诊。主要风险是肺嵌顿和坏死,对于大的缺损,还会因反常呼吸导致通气困难。治疗首先是手术治疗,但存在争议,应考虑其位置、大小、病程长短以及可能的感染情况。我们报告了一例因阵咳诱发的右胸底部肺疝病例,患者患有慢性支气管炎。