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題名 | Tension Pneumopericardium after Removal of a Pericardial Drainage Catheter--Case Report=拔除心包引流導管後產生張力性心包積氣--個案報告 |
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作者 | 許永毅; 謝俊民; 柯獻欽; Khor, Eng-guan; Shieh, Jiunn-min; Ko, Shian-chin; |
期刊 | 胸腔醫學 |
出版日期 | 20131200 |
卷期 | 28:6 2013.12[民102.12] |
頁次 | 頁354-359 |
分類號 | 415.3164 |
語文 | eng |
關鍵詞 | 心包積氣; 心包引流; Pneumopericardium; Pericardiocentesis; Pericardial drainage; |
中文摘要 | 心包積氣是胸腔外傷所造成的罕見併發症,但它也可能由醫源性原因導致,如:使用呼吸器、心包穿刺術。心包積氣可能快速惡化而造成心臟血管循環系統衰竭,此時稱之為張力性心包積氣,需要緊急做心包引流術。我們報告一位成年男性病人,起始表現為兩側肺炎併心包積液,接受心包穿刺術併豬尾巴導管置入,引流數天後在拔除導管時,卻立即發生張力性心包積氣、縱膈積氣、氣胸與皮下氣腫,出現心臟填塞徵候,病人緊急接受心包膜開窗術。張力性心包積氣是可能危及生命的併發症,需要立即診斷與妥善治療。 |
英文摘要 | Pneumopericardium is an uncommon complication of blunt or penetrating chest trauma. It may also occur iatrogenically, e.g., as a result of thoracic procedures, endoscopy, mechanical ventilation and pericardiocentesis. Tension pneumopericardium may progress rapidly, leading to cardiovascular compromise or circulatory collapse, and require emergent drainage of the pericardial sac. We describe the case of a patient with bilateral pneumonia and pericardial effusion. The patient underwent pericardiocentesis with pigtail drainage; however, subcutaneous emphysema, pneumopericardium, pneumomediastinum and pneumothorax developed immediately after removal of the drain catheter. Cardiac tamponade signs were noted. The patient underwent emergency pericardial window operation. Pneumopericardium is a rare complication of pericardiocentesis, occurring either as a result of direct pleuro-pericardial communication or a leaky drainage system. Although there have been several case reports in the literature describing pneumopericardium associated with pericardiocentesis, none had concurrent pneumothorax and/or pneumomediastinum. |
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