Aragão Antonio Higor Marques, Fonseca Letícia Aguiar, Deulefeu Flávio Clemente, Medeiros Israel Lopes, de Araújo Rafael Fernandes Viana, da Cruz Neto Carlos Alberto, Neto Antero Gomes
College of Medicine, Universidade Estadual do Ceará, Fortaleza, CE, Brazil.
Department of Pulmonology, Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
Case Rep Pulmonol. 2020 Jan 23;2020:5026759. doi: 10.1155/2020/5026759. eCollection 2020.
Spontaneous hemopneumothorax is a rare and potentially life-threatening disorder which complicates about 1-12% of patients presenting with spontaneous pneumothorax and has a remarkable predilection for male patients. It may present with signs of hypovolemic shock without apparent cause. While there are no specific guidelines for the management of patients diagnosed with such condition, wide debate in the literature relating to patient selection for surgery remains unresolved, and recently there seems to be a trend increasingly favorable towards early surgical intervention. Video-assisted thoracic surgery emerges as an excellent option for stable patients and has now been considered the gold standard treatment for spontaneous hemopneumothorax. We report the case of a 17-year-old male patient who presented to the emergency department with a history of sudden chest pain and dyspnea, with no previous evidence of trauma. On admission, the patient presented with hypotension, tachycardia, and cutaneous pallor. Chest X-ray showed hydropneumothorax on the left hemithorax; then, chest tube was placed with an initial drainage of 2000 ml of blood.
自发性血气胸是一种罕见且可能危及生命的疾病，在自发性气胸患者中约占1% - 12%，且明显更易发生于男性患者。它可能无明显诱因地出现低血容量休克的体征。虽然对于诊断为此类病症的患者的管理尚无具体指南，但文献中关于手术患者选择的广泛争论仍未解决，且最近似乎有越来越倾向于早期手术干预的趋势。电视辅助胸腔镜手术已成为稳定患者的极佳选择，目前被认为是自发性血气胸的金标准治疗方法。我们报告一例17岁男性患者，该患者因突发胸痛和呼吸困难病史就诊于急诊科，既往无创伤史。入院时，患者出现低血压、心动过速和皮肤苍白。胸部X线显示左半胸液气胸；随后放置胸腔引流管，初始引流出2000毫升血液。
