一例食管癌切除术后采用碘油淋巴造影治疗乳糜胸引发急性呼吸窘迫综合征的病例。
A case of acute respiratory distress syndrome due to lymphography with Lipiodol for chylothorax after esophagectomy.
作者信息
Taki Yusuke, Sato Shinsuke, Suzuki Katsunori, Nagai Erina, Watanabe Masaya, Shishido Yuichiro, Nakajima Nobuaki, Takagi Masakazu
机构信息
Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-ku, Shizuoka City, 420-8527, Japan.
Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka City, Japan.
出版信息
Surg Case Rep. 2019 Jan 3;5(1):1. doi: 10.1186/s40792-018-0560-y.
BACKGROUND
Lymphography with Lipiodol is useful for chylothorax. There were many slight complications, but reports of acute respiratory distress syndrome (ARDS) after lymphography were few.
CASE PRESENTATION
A 75-year-old man with esophageal cancer developed chylothorax after esophagectomy. Conservative treatment was ineffective, and he underwent lymphography with 8.5 mL of Lipiodol. He developed a high fever soon after lymphography, followed by severe ARDS requiring artificial respiration 5 days later. He recovered from ARDS but subsequently developed pulmonary fibrosis and was discharged with domiciliary oxygen therapy 3 months later.
CONCLUSION
Although ARDS is a rare complication of lymphography with Lipiodol, this procedure should be applied carefully in patients with chylothorax.
背景
碘油淋巴造影对乳糜胸有诊断价值。该检查存在许多轻微并发症，但碘油淋巴造影后发生急性呼吸窘迫综合征（ARDS）的报道较少。
病例报告
一名75岁食管癌男性患者在食管切除术后发生乳糜胸。保守治疗无效后，他接受了8.5毫升碘油的淋巴造影检查。淋巴造影后不久他出现高热，5天后发展为严重ARDS，需要进行人工呼吸。他从ARDS中康复，但随后出现肺纤维化，3个月后接受家庭氧疗出院。
结论
尽管ARDS是碘油淋巴造影的罕见并发症，但对于乳糜胸患者，应谨慎应用该检查。
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