Baba M, Yokoi H, Yamashita A, Sugimoto S, Izumiyama O, Hasegawa T
Department of Cardiovascular Surgery, Hakodate Municipal Hospital, Japan.
Kyobu Geka. 1998 Oct;51(11):970-3.
A 21-year-old man; complaining of left chest pain and dyspnea, was admitted to our hospital with a diagnosis of spontaneous pneumothorax. Though chest X-ray on admission did not show hemothorax, chest drainage revealed intrapleural bleeding. As chest X-ray on the following day showed evident fluid level, emergency operation was carried out with a diagnosis of spontaneous hemopneumothorax. Bleeding point was a ruptured vessel between parietal pleura and bulla in apex of lung. The bulla was resected following hemostasis. After improvement of complicating postoperative re-expansive pulmonary edema, the patient was discharged on the 18th postoperative day. On treatment of spontaneous hemopneumothorax, existence of such a case as ours should be taken into account.
一名21岁男性,因左侧胸痛和呼吸困难入院,诊断为自发性气胸。入院时胸部X线检查未显示血胸,但胸腔引流发现胸腔内出血。次日胸部X线显示明显的液平面,诊断为自发性血气胸后进行了急诊手术。出血点是肺尖部壁层胸膜与肺大疱之间的血管破裂。止血后切除了肺大疱。术后并发的复张性肺水肿改善后,患者于术后第18天出院。在治疗自发性血气胸时,应考虑到我们这样的病例的存在。