Balks Maren Friederike, Gosemann Jan-Hendrik, Sorge Ina, Lacher Martin, Hirsch Franz Wolfgang
Departement of Pediatric Surgery, Universitatsklinikum Leipzig, Leipzig, Sachsen, Germany.
Departement of Pediatric Radiology, Universitatsklinikum Leipzig, Leipzig, Sachsen, Germany.
European J Pediatr Surg Rep. 2018 Jan;6(1):e63-e65. doi: 10.1055/s-0038-1667357. Epub 2018 Aug 22.
We report the case of a 3-year-old boy who presented with an upper respiratory tract infection and severe dyspnea. A chest X-ray revealed a left-sided tension pneumothorax with mediastinal shift and suspected enterothorax. After thoracic computed tomography (CT) scan, a chest tube was inserted, which drained fluid which had the same consistency and color as the one derived from the nasogastric (NG) tube. The boy underwent diagnostic laparoscopy for suspected bowel perforation, which confirmed a left-sided Bochdalek hernia with herniation of the viscera into the chest. After repositioning of the herniated organs into the abdomen, a gastric perforation was identified and repaired. This case demonstrates that the cause of a tension pneumothorax in an infant may be a rare combination of congenital diaphragmatic hernia (CDH) and perforation of a visceral hollow organ.
我们报告了一名3岁男孩的病例，该男孩出现上呼吸道感染并伴有严重呼吸困难。胸部X光显示左侧张力性气胸伴纵隔移位，并怀疑有胸腹裂孔疝。经胸部计算机断层扫描（CT）后，插入了胸管，引流出来的液体与经鼻胃管引出的液体在稠度和颜色上相同。该男孩因怀疑肠穿孔接受了诊断性腹腔镜检查，结果证实为左侧Bochdalek疝，伴有内脏疝入胸腔。将疝出的器官重新放回腹腔后，发现了胃穿孔并进行了修复。该病例表明，婴儿张力性气胸的病因可能是先天性膈疝（CDH）和内脏中空器官穿孔这一罕见组合。
