<原著>嚢胞内貯水と自発性気胸とを来した両側巨大気腫性嚢胞症の 1 例

Abstract

A 66-years old retired businessman with bilateral giant emphysematous bullae was admitted because of fever, cough, dyspnea and right chest pain. On admission, the radiological examination showed the sign of pulmonary infection with intra-bullous fluid retention in the right upper lobe. The pneumothorax which developed to sever respiratory failure was induced by thoracentesis done in order to aspirate the fluid. After continous air aspiration by means of No. 8 Nelation's Catheter for 10 days, the pneumothorax was cured, and at the same time, the infected giant bullae shrinked with surrounding lung tissue. About 2 months later, the patient was discharged. After about 3 months life at home, another spontaneous pneumothorax in opposite side (left) with severe respiratory failurc occured. As the sufficient re-inflation of the left lung was not able to be obtained, in spite of energic continuous air aspiration for 3 weeks, the thoracotomy and ligature of the punctured bullae were performed successfully under very poor risk condition. In relation to this interestingly proceeded case, some points about the shrinkage of the infected bullae and the criteria concerning the operation shifted from the continuous air aspiration of spontaneous pneumothorax are discussed in this paper.