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巨大肺大疱或气胸:如何鉴别。

Giant bulla or pneumothorax: How to distinguish.

作者信息

Aramini Beatrice, Ruggiero Ciro, Stefani Alessandro, Morandi Uliano

机构信息

Division of Thoracic Surgery, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Via Largo del Pozzo n. 71, 41124, Modena, Italy.

出版信息

Int J Surg Case Rep. 2019;62:21-23. doi: 10.1016/j.ijscr.2019.08.003. Epub 2019 Aug 8.

Abstract

BACKGROUND

The differential diagnosis between pneumothorax and giant bullae is thought to be straightforward but sometimes poses a challenge.

CASE PRESENTATION

We present a case of a 54-year-old Caucasian man with a giant emphysematous bulla who underwent surgical resection. He had no smoking history and had previous pneumonia episodes. The surgery was free of complications, without air leaks, and he showed good ventilation of the lung.

DISCUSSION

The main complications of bullae are pneumothorax, infection and hemorrhage. Pneumothorax is a serious complication in patients with compromised lung function. Therefore, it is very important to carefully distinguish bullae from pneumothorax to avoid iatrogenic pneumothorax in patients with bullous disease.

CONCLUSION

We emphasize how to differentiate between giant bullae and pneumothorax utilizing history, physical examination, and radiological studies, including computed tomography (CT) scan.

摘要

背景

气胸与巨大肺大疱之间的鉴别诊断通常被认为较为简单直接,但有时也会带来挑战。

病例报告

我们报告一例54岁的白种男性患者,患有巨大肺气肿性肺大疱,接受了手术切除。他无吸烟史,既往有肺炎发作史。手术无并发症,无漏气情况,且肺部通气良好。

讨论

肺大疱的主要并发症为气胸、感染和出血。气胸在肺功能受损的患者中是一种严重并发症。因此,仔细区分肺大疱与气胸对于避免大疱性疾病患者发生医源性气胸非常重要。

结论

我们强调如何利用病史、体格检查以及包括计算机断层扫描(CT)在内的影像学检查来鉴别巨大肺大疱与气胸。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dddc/6702430/4f0d7058a539/gr1.jpg

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