A case of chronic hemorrhagic pyothorax treated by multi-stage operation including omentopexy
Noriaki Tezuka,Shozo Fujino,Shuhei Inoue,Keiichi Kontani,Satoru Sawai,Jun Hanaoka,Masutaro Ichinose,Atsumi Mori +7 more
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TL;DR: Hydrocarbon-free drinking water is a viable option for all but the fittestimmers, according to new guidelines.
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Abstract: 慢性出血性膿胸 (縦隔圧迫型膿胸, 進行性出血性膿胸) は, 通常の膿胸とは異なり易出血性で, 治癒困難な膿胸である.安易な胸腔ドレナージや, 開胸血腫除去は大量出血をきたす.肺結核のために施行した胸膜外充填術後33年目に発症した慢性出血性膿胸に対し, 開放術, 血管結紮術, 大網充填術で治癒せしめた1例を経験したので報告する.症例は58歳女性, 発熱に伴い右胸部の腫脹が増大したため当科紹介受診となった.25歳時に肺結核に対して胸膜外充填術を施行されている.胸部単純X線および胸部CT写真では右上中肺野から胸腔外に突出する腫瘤陰影を認め, 第1～5肋骨の破壊像が認められた.感染を伴った皮下の腫瘤を開放し, 胸肩峰動脈, 内胸動脈の結紮, 気管支動脈の塞栓術を施行した後に胸腔内血腫除去術を行った.気管支瘻に対しては開放療法後, 有茎大網弁被覆充填術を施行した.胸腔内血腫除去に先立つ血管結紮, 塞栓術は有効であった.
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Citations
A case of chronic expanding hematoma resulting in fatal hemoptysis.
Yoshinobu Hata,Susumu Sakamoto,Nobuyuki Shiraga,Keita Sato,Fumitomo Sato,Hajime Otsuka,Hidenori Goto,Keigo Takagi,Yoshinori Watanabe +8 more
TL;DR: An 80-year-old woman presented with a huge intrathoracic mass which had increased in size over 4 years, and was hospitalized with cardiac tamponade and subsequent massive hemoptysis, and the patient soon succumbed.
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