Venkitakrishnan Rajesh, Augustine Jolsana, Ramachandran Divya, Cleetus Melcy
Department of Pulmonary Medicine, Rajagiri Hospital, Aluva, Kochi, Kerala, India.
Lung India. 2023 Mar-Apr;40(2):169-172. doi: 10.4103/lungindia.lungindia_517_22.
Pneumothorax is a frequently encountered entity in pulmonary practice and can be primary or secondary. Traumatic and iatrogenic causes also account for a minority of cases presenting to the chest physician. The most common therapeutic intervention done is a tube thoracostomy in all but the mildest of cases. Pneumothorax ex vacuo is a distinctly uncommon entity that differs considerably from the rest of the pneumothorax cases in its pathogenesis, clinical manifestations, radiological findings, and management. Pneumothorax in this entity results from the sucking in of air into the pleural space caused by an exaggerated negative intrapleural pressure, which is most frequently secondary to acute lobar collapse. Symptoms attributable to pneumothorax per se are distinctly mild and the vital aspect of treatment is to relieve the bronchial obstruction. Tube thoracostomy fails to relieve the pneumothorax in such cases and should be avoided. We share three cases of pneumothorax ex vacuo encountered in our institution and alert clinicians of the presentation, radiology, and management of this uncommon condition.
气胸是肺部临床中常见的病症，可分为原发性或继发性。创伤性和医源性原因导致的气胸在胸科医生接诊的病例中占少数。除最轻微的病例外，最常见的治疗干预措施是胸腔闭式引流术。肺被压缩性气胸是一种极为罕见的病症，在发病机制、临床表现、影像学表现及治疗方法上与其他气胸病例有很大差异。该病症中的气胸是由于胸膜腔内负压过大，空气被吸入胸膜腔所致，最常见的原因是急性肺叶萎陷。气胸本身引起的症状明显较轻，治疗的关键在于解除支气管阻塞。在这种情况下，胸腔闭式引流术无法缓解气胸，应避免使用。我们分享了本院遇到的三例肺被压缩性气胸病例，并提醒临床医生注意这种罕见病症的临床表现、影像学表现及治疗方法。
