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急性淋巴细胞白血病及化疗后并发纵隔气肿、心包积气和皮下气肿:一例报告

Pneumomediastinum, pneumopericardium and subcutaneous emphysema following acute lymphoblastic leukemia and chemotherapy: A case report.

作者信息

Kajiyazdi Mohammad, Norooznezhad Amir Hossein

机构信息

Pediatric Hematology and Oncology Ward, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Caspian J Intern Med. 2021;12(Suppl 2):S379-S382. doi: 10.22088/cjim.12.0.379.

Abstract

BACKGROUND

Pneumomediastinum and subcutaneous emphysema are mostly detected in non-malignant conditions such as certain infections, thoracic surgeries, and trauma. Although this condition is asymptomatic in most cases, sometimes it could be symptomatic and may even be lethal in some patients.

CASE PRESENTATION

This letter reports a 9-year-old girl with acute lymphoblastic leukemia (ALL) on chemotherapy who developed pneumothorax with the clinical feature of respiratory distress for that a chest tube was inserted immediately. Following the insertion, pneumomediastinum and pneumopericardium developed in the patient. As the next step, a pericardium window was inserted by an expert heart surgeon. During these procedures, all the evaluations for any bacterial or fungal infection were negative. Unfortunately, the patient expired before any further complementary evaluations and it was not clear that the mentioned situation was a result of chemotherapy or ALL.

CONCLUSION

Although pneumomediastinum and subcutaneous emphysema are rare in patients with ALL, authors strongly suggest clinicians consider them in any similar patients presenting respiratory signs/symptoms for faster onset of action.

摘要

背景

纵隔气肿和皮下气肿大多在某些感染、胸外科手术和创伤等非恶性疾病中被发现。虽然这种情况在大多数病例中无症状,但有时可能有症状,甚至在某些患者中可能致命。

病例报告

本文报告一名9岁接受化疗的急性淋巴细胞白血病(ALL)女孩,她出现气胸并伴有呼吸窘迫的临床特征,因此立即插入了胸管。插入胸管后,患者出现了纵隔气肿和心包积气。下一步,一位心脏外科专家插入了心包开窗引流。在这些操作过程中,所有针对任何细菌或真菌感染的评估均为阴性。不幸的是,患者在进行任何进一步的补充评估之前死亡,尚不清楚上述情况是化疗还是ALL所致。

结论

虽然ALL患者中纵隔气肿和皮下气肿很少见,但作者强烈建议临床医生在任何出现呼吸体征/症状的类似患者中考虑到这些情况,以便更快采取行动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e380/8559649/94b56bc56eb5/cjim-12-379-g001.jpg

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