Ng Boon Hau, Low Hsueh Jing, Nik Abeed Nik Nuratiqah, Jailaini Mas Fazlin Mohamad, Abdul Hamid Mohamed Faisal, Ban Yu-Lin Andrea
Pulmonology Unit, Department of Internal Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia.
Department of Anesthesiology & Intensive Care Unit, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia.
Respirol Case Rep. 2023 Apr 12;11(5):e01143. doi: 10.1002/rcr2.1143. eCollection 2023 May.
We report a 35-year-old woman who presented with dyspnoea and chest pain for 1 week. High-resolution computed tomography (HRCT) thorax revealed bilateral pneumothoraces with diffuse lung cysts. Bilateral intercostal chest tubes were inserted, and there was a persistent air leak (PAL) bilaterally. We performed an autologous blood patch pleurodesis (ABPP) for the left PAL. For the right PAL, she underwent a successful right video-assisted thoracic (VATS) surgery, wedge biopsy, and surgical pleurodesis. Histopathology examination confirmed the diagnosis of lymphangioleiomyomatosis (LAM). The left pneumothorax recurred. An indwelling pleural catheter (Rocket® IPC™; Rocket Medical plc; WASHINGTON) was inserted and the patient was discharged after 1 day with an atrium pneumostat (Pneumostat™; Atrium Medical Corporation, Hudson, NH, USA) chest drain valve. The patient was initiated on Sirolimus 2 mg daily. The left PAL resolved at 6 weeks. This case highlights the benefit of IPC with an ambulatory pneumothorax device in a patient with LAM with PAL.
我们报告一名35岁女性，她出现呼吸困难和胸痛1周。胸部高分辨率计算机断层扫描（HRCT）显示双侧气胸伴弥漫性肺囊肿。双侧插入肋间胸腔引流管，双侧均存在持续性漏气（PAL）。我们对左侧PAL进行了自体血贴片胸膜固定术（ABPP）。对于右侧PAL，她接受了成功的右电视辅助胸腔镜（VATS）手术、楔形活检和手术胸膜固定术。组织病理学检查确诊为淋巴管平滑肌瘤病（LAM）。左侧气胸复发。插入了一根留置胸膜导管（Rocket® IPC™；Rocket Medical plc；华盛顿），患者在1天后带着心房气胸调节器（Pneumostat™；Atrium Medical Corporation，美国新罕布什尔州哈德逊）胸腔引流阀出院。患者开始每日服用2毫克西罗莫司。左侧PAL在6周时消失。该病例突出了在患有LAM合并PAL的患者中使用带门诊气胸装置的IPC的益处。
