Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
BMJ Case Rep. 2021 Mar 1;14(3):e241510. doi: 10.1136/bcr-2020-241510.
A 31-year-old female physician was diagnosed with bilateral pneumothorax a day after her acupuncture treatment. Her body mass index was 16.9 and she did not have a prior history of respiratory disease or smoking. Acupuncture needles may easily reach the pleura around the end of the suprascapular angle of the levator scapulae muscle where the subcutaneous tissue is anatomically thin. In our patient, the thickness between the epidermis and the visceral pleura in this area was only 22 mm as confirmed by an ultrasound scan. Although she felt chest discomfort 30 min after the procedure, she assumed the symptom to be a reaction to the acupuncture. In light of our case, we advise practitioners to select appropriate acupuncture needles for patients based on the site of insertion and counsel them regarding the appearance of symptoms such as chest pain and dyspnoea immediately after the procedure.
一位 31 岁的女医生在接受针灸治疗一天后被诊断为双侧气胸。她的体重指数为 16.9，没有呼吸系统疾病或吸烟史。针灸针很容易到达斜方肌肩胛提肌止点附近的胸膜，此处皮下组织解剖上较薄。在我们的患者中，通过超声检查确认，该区域表皮与内脏胸膜之间的厚度仅为 22mm。尽管她在治疗后 30 分钟感到胸部不适，但她认为这是对针灸的反应。鉴于我们的病例，我们建议医生根据进针部位选择合适的针灸针，并在治疗后立即告知患者有关胸痛和呼吸困难等症状的出现。
