双心室植入式心律转复除颤器植入术后双侧气胸：一例水牛胸综合征病例
Bilateral Pneumothoraces Following BiV ICD Placement: A Case of Buffalo Chest Syndrome.
作者信息
Rali Aniket S, Manyam Harish
机构信息
Department of Internal Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.
Department of Electrophysiology, Harrington Heart and Vascular Institute, Cleveland, OH, USA.
出版信息
Am J Case Rep. 2015 Oct 2;16:703-6. doi: 10.12659/AJCR.894671.
BACKGROUND
Contralateral pneumothorax following device implantation on the left side has been reported in a few cases. The majority of contralateral pneumothoraces showed evidence of atrial perforation on computed tomography (CT), echocardiography, or chest x-rays and required lead revision. To the best of our knowledge there is only 1 other reported case of contralateral pneumothorax without evidence of macro-displacement of the atrial lead. In that case the patient experienced a right-sided pneumothorax on day 1 after undergoing repositioning of the atrial lead.
CASE REPORT
The current case is unique on several accounts, including timing of the contralateral pneumothorax and no evidence of associated atrial lead perforation on device interrogation or CT imaging. Furthermore, the appearance of contralateral pneumothorax within 8 hours of clamping of the ipsilateral chest tube argues in favor of a pleuro-pleural fistula.
CONCLUSIONS
The term 'buffalo chest' refers to a single pleural space, with no anatomical separation of the 2 hemithoraces, as seen in an American buffalo or bison. We believe this to be a case of buffalo chest syndrome.
背景
左侧植入装置后发生对侧气胸的病例已有少数报道。大多数对侧气胸在计算机断层扫描（CT）、超声心动图或胸部X线检查中显示有心房穿孔的迹象，需要更换导线。据我们所知，仅有1例其他报道的对侧气胸病例，且心房导线无明显移位。在该病例中，患者在心房导线重新定位后第1天出现右侧气胸。
病例报告
本病例在多个方面具有独特性，包括对侧气胸的发生时间，以及在装置检查或CT成像中无相关心房导线穿孔的证据。此外，同侧胸管夹闭后8小时内出现对侧气胸，提示存在胸膜-胸膜瘘。
结论
“水牛胸”一词指的是单一胸膜腔，两个半侧胸腔无解剖分隔，就像美洲水牛或野牛那样。我们认为这是一例水牛胸综合征病例。
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