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胸管的异常位置，位于胸腔内但在胸膜外。

Unusual Malposition of a Chest Tube, Intrathoracic but Extrapleural.

作者信息

Al Mosa Alqasem Fuad H, Ishaq Mohammed, Ahmed Mohamed Hussein Mohamed

机构信息

ATA, King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh, Saudi Arabia.

Surgery, King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh, Saudi Arabia.

出版信息

Case Rep Radiol. 2018 Aug 6;2018:8129341. doi: 10.1155/2018/8129341. eCollection 2018.

DOI:10.1155/2018/8129341
PMID:30174979
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6106908/
Abstract

Chest tube malpositioning is reported to be the most common complication associated with tube thoracostomy. Intraparenchymal and intrafissural malpositions are the most commonly reported tube sites. We present a case about a 21-year-old patient with cystic fibrosis who was admitted due to bronchiectasis exacerbation and developed a right-sided pneumothorax for which a chest tube was inserted. Partial initial improvement in the pneumothorax was noted on the chest radiograph, after which the chest tube stopped functioning and the pneumothorax remained for 19 days. Chest computed tomography was done and revealed a malpositioned chest tube in the right side located inside the thoracic cavity but outside the pleural cavity (intrathoracic, extrapleural). The removed chest tube was patent with no obstructing materials in its lumen. A new thoracostomy tube was inserted and complete resolution of the pneumothorax followed.

摘要

据报道，胸管位置不当是与胸腔闭式引流术相关的最常见并发症。实质内和裂隙内位置不当是最常报道的胸管位置。我们报告一例21岁的囊性纤维化患者，因支气管扩张加重入院，并发右侧气胸，遂插入胸管。胸部X光片显示气胸有部分初步改善，之后胸管停止发挥作用，气胸持续了19天。进行了胸部计算机断层扫描，结果显示右侧胸管位置不当，位于胸腔内但在胸膜腔外（胸腔内，胸膜外）。取出的胸管通畅，管腔内没有阻塞物。插入了一根新的胸腔造口管，随后气胸完全消退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/17b91977463c/CRIRA2018-8129341.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/a9c3cc51aaa9/CRIRA2018-8129341.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/6ee3fe5100e2/CRIRA2018-8129341.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/0b53857cbf4b/CRIRA2018-8129341.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/76e4158ace52/CRIRA2018-8129341.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/af82e1e8cadb/CRIRA2018-8129341.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/17b91977463c/CRIRA2018-8129341.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/a9c3cc51aaa9/CRIRA2018-8129341.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/6ee3fe5100e2/CRIRA2018-8129341.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/0b53857cbf4b/CRIRA2018-8129341.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/76e4158ace52/CRIRA2018-8129341.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/af82e1e8cadb/CRIRA2018-8129341.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fcd/6106908/17b91977463c/CRIRA2018-8129341.006.jpg

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本文引用的文献

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Life threatening hemoperitoneum and liver injury as a result of chest tube thoracostomy.胸腔闭式引流术导致危及生命的腹腔积血和肝损伤。
Clin Med Insights Case Rep. 2015 Feb 26;8:15-7. doi: 10.4137/CCRep.S23139. eCollection 2015.
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Results of thoracic drainages placed in air rescue.空中救援中胸腔引流的结果。
Trauma Case Rep. 2021 Mar 17;32:100461. doi: 10.1016/j.tcr.2021.100461. eCollection 2021 Apr.
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Can J Surg. 2007 Dec;50(6):450-8.
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Incidence of chest tube malposition in the critically ill: a prospective computed tomography study.危重症患者胸管位置异常的发生率：一项前瞻性计算机断层扫描研究。
Anesthesiology. 2007 Jun;106(6):1112-9. doi: 10.1097/01.anes.0000267594.80368.01.
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Diagnosis of malpositioned chest tubes after emergency tube thoracostomy: is computed tomography more accurate than chest radiograph?急诊胸腔闭式引流术后胸管位置异常的诊断：计算机断层扫描是否比胸部X线片更准确？
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