Konobu T, Saitoh Y, Umemoto M, Hino Y, Ohmiya H, Imamura H
Department of Thoracic Surgery, Kansai Medical University, Osaka, Japan.
Kyobu Geka. 1997 Aug;50(9):796-9.
A 44-year-old man was admitted to out hospital complaining of chest pain and increasing dyspnea. Chest X-ray on admission revealed a collapsed lung and an air fluid line in the left hemothorax. Following blood transfusion because of 2,000 ml hemorrhagic pleural fluid, emergent surgery was carried out. At operation, a bleeding artery originating from the apex of the thoracic cavity and a bulla on the upper lobe were noticed. After extubation of endotracheal tube, he offered severe dyspnea with hypoxia. The chest X-ray showed figure of pulmonary edema in the left lower lobe. Patient was managed by oxygen, steroid, and urinastatin. On the 3rd operative day, pulmonary edema was disappeared. It should be kept in the mind that the re-expansion pulmonary edema occurred in patients with spontaneous hemopneumothorax of less than 3 days of duration.
一名44岁男性因胸痛和进行性呼吸困难入院。入院时胸部X线显示左肺萎陷，左侧血胸内有气液平面。因胸腔内出血2000ml行输血治疗后，急诊手术。术中发现一根起源于胸腔顶部的出血动脉和上叶的一个肺大疱。气管插管拔除后，患者出现严重呼吸困难伴低氧血症。胸部X线显示左下叶肺水肿影像。给予患者吸氧、类固醇和乌司他丁治疗。术后第3天，肺水肿消失。应牢记，复张性肺水肿发生于病程小于3天的自发性血气胸患者。
