Walker Brandon L, Boster Joshua, Syed Azfar S, Huprikar Nikhil, Sjulin Tyson
Pulmonary and Critical Care, San Antonio Uniformed Services Health Education Consortium, San Antonio, USA.
Internal Medicine, Brooke Army Medical Center, Fort Sam Houston, USA.
Cureus. 2020 Jul 11;12(7):e9141. doi: 10.7759/cureus.9141.
Patients with chronic obstructive pulmonary disease (COPD) are at an increased risk for numerous pulmonary complications, including secondary spontaneous pneumothorax (SSP) and lung herniation. We describe the case of a 66-year-old female patient with severe COPD and previous lingula-sparing left upper lobectomy from adenocarcinoma who presented to the emergency department with a painful anterior chest wall mass that varied in size with respiration. This finding, in a patient with a prior history of an invasive thoracic procedure, is suggestive of lung herniation. Further investigation revealed an SSP mimicking the classic physical exam finding of a lung herniation. The patient was deemed a poor surgical candidate; therefore, talc pleurodesis was administered with resolution of the pneumothorax.
慢性阻塞性肺疾病（COPD）患者发生多种肺部并发症的风险增加，包括继发性自发性气胸（SSP）和肺疝。我们描述了一例66岁女性患者，她患有严重的COPD，既往因腺癌行保留舌叶的左上肺叶切除术，现因呼吸时大小变化的前胸痛性胸壁肿块就诊于急诊科。在有侵入性胸部手术史的患者中出现这一发现提示肺疝。进一步检查发现了一例模仿肺疝典型体格检查结果的SSP。该患者被认为是手术的不良候选者；因此，给予滑石粉胸膜固定术，气胸得到缓解。
