保存的治療にて改善を得た肺軸捻転症の1例

概要

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A 74-year-old female had left upper lobectomy for lung cancer. Torsion of the lower lobe occurred 24 hours later. The diagnosis was made from chest x-ray films and bronchofiberscopic findings. Chest x-ray films showed an opaque shadow in the left lower lobe which increased gradually in density and finally developed into atelectasis. Bronchofiberscopy showed narrowing of the lower lobe bronchus and 90-degree clockwise torsion of the B6 bronchus. Complete occlusion was noted 48 hours after surgery. Since her condition was good, conservative treatment was chosen instead of a seconed thoracotomy.<BR>After 14 days, the torsion had improved ; the patient is now well 30 months after surgery. According to the literature, spontaneous improvement of pulmonary torsion is very rare. The prognosis seems to depend on the degree of torsion. When it is less than 180 degrees, improvement may occur without thoracotomy.<BR>Therefore bronchofiberscopical procedure is important to determine the degree of torsion.
特定非営利活動法人日本呼吸器外科学会の論文