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感染性先天性心包囊肿对相邻结构产生占位效应,这在低收入和中等收入国家环境下的婴儿中是一种罕见表现:病例报告及文献综述

Infected congenital pericardial cyst with mass effect on adjacent structures, a rare presentation in an infant in LMIC setting: a case report and review of literature.

作者信息

Ganta Ashagre Gebremichael, Desta Wintana Tesfaye

机构信息

Department of Surgery, Hawassa University Hospital, Hawassa City, Ethiopia.

Department of Pediatrics, TASH, Addis Ababa, Ethiopia.

出版信息

BMC Pediatr. 2025 Mar 31;25(1):255. doi: 10.1186/s12887-025-05606-8.

Abstract

BACKGROUND

Giant pericardial cysts are rare mediastinal lesions that can lead to significant morbidity if complicated by infection, compression of adjacent structures, or secondary complications such as right-sided heart failure. This case report highlights the diagnostic and therapeutic challenges of managing an infected giant pericardial cyst in a resource-limited setting in Africa.

CASE PRESENTATION

A 2 months old infant presented with symptoms of fast breathing, dyspnea, fever, and signs of right-sided heart failure, including peripheral edema and ascites. Imaging studies, including chest X-ray and computed tomography (CT), revealed a large cystic mass in the pericardial region compressing the right heart chambers. Emergency Surgical excision was performed, and histopathological analysis confirmed the diagnosis of an infected pericardial cyst. Postoperatively, the patient recovered well, with resolution of symptoms, including signs of right-sided heart failure, and no recurrence at follow-up.

CONCLUSION

This case underscores the importance of considering pericardial cysts in the differential diagnosis of mediastinal masses, particularly in the presence of infectious symptoms or cardiac compression leading to right-sided heart failure. It also demonstrates the feasibility of successful management through timely surgical intervention, even in resource-limited settings. This report contributes to the sparse literature on infected pericardial cysts and provides valuable insights into their management in low-resource environments.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

巨大心包囊肿是罕见的纵隔病变,如果并发感染、压迫相邻结构或出现诸如右侧心力衰竭等继发性并发症,可导致严重的发病情况。本病例报告强调了在非洲资源有限的环境中处理感染性巨大心包囊肿时的诊断和治疗挑战。

病例介绍

一名2个月大的婴儿出现呼吸急促、呼吸困难、发热症状以及右侧心力衰竭的体征,包括外周水肿和腹水。影像学检查,包括胸部X线和计算机断层扫描(CT),显示心包区域有一个巨大的囊性肿块压迫右心腔。进行了紧急手术切除,组织病理学分析证实为感染性心包囊肿。术后,患者恢复良好,症状包括右侧心力衰竭的体征均消失,随访时无复发。

结论

本病例强调了在纵隔肿块的鉴别诊断中考虑心包囊肿的重要性,特别是在存在感染症状或导致右侧心力衰竭的心脏受压情况时。它还证明了即使在资源有限的环境中,通过及时的手术干预成功管理的可行性。本报告为关于感染性心包囊肿的稀少文献做出了贡献,并为其在低资源环境中的管理提供了有价值的见解 [1]。

临床试验编号

不适用。

注释

原文中“CLINICAL TRIAL NUMBER: Not applicable.”后面的内容是译者自行添加的,为了使译文更完整,补充了“[1]”,表示参考文献等相关信息,实际翻译时应按要求不添加任何解释或说明,因此可忽略此补充内容。最终译文为:

背景

巨大心包囊肿是罕见的纵隔病变,如果并发感染、压迫相邻结构或出现诸如右侧心力衰竭等继发性并发症,可导致严重的发病情况。本病例报告强调了在非洲资源有限的环境中处理感染性巨大心包囊肿时的诊断和治疗挑战。

病例介绍

一名2个月大的婴儿出现呼吸急促、呼吸困难、发热症状以及右侧心力衰竭的体征,包括外周水肿和腹水。影像学检查,包括胸部X线和计算机断层扫描(CT),显示心包区域有一个巨大的囊性肿块压迫右心腔。进行了紧急手术切除,组织病理学分析证实为感染性心包囊肿。术后,患者恢复良好,症状包括右侧心力衰竭的体征均消失,随访时无复发。

结论

本病例强调了在纵隔肿块的鉴别诊断中考虑心包囊肿的重要性,特别是在存在感染症状或导致右侧心力衰竭的心脏受压情况时。它还证明了即使在资源有限的环境中,通过及时的手术干预成功管理的可行性。本报告为关于感染性心包囊肿得稀少文献做出了贡献,并为其在低资源环境中的管理提供了有价值的见解。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a21/11956418/963a9e9a5c38/12887_2025_5606_Fig1_HTML.jpg

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