Die traumatische Pneumatocele — Ein Fallbericht

Zusammenfassung Die posttraumatische Pneumatocele ist eine seltene intrapulmonale Veränderung nach stumpfem Thoraxtrauma. Anhand eines gut dokumentierten Falles wird diese seltene Form der Lungenkontusion dargestellt und die klinisch bedeutsame Differentialdiagnose diskutiert.

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Traumatic pneumatocele — a case report

Summary The posttraumatic pneumatocele is a rare intrapulmonary lesion following blunt thoracic injury. By means of a well documented case report this rare form of lung contusion is demonstrated and the clinically important differential diagnosis is discussed.

     

胸腔镜联合医用OB胶治疗肺大疱致自发性气胸

目的：临床评价胸腔镜联合医用OB胶治疗肺大疱致自发性气胸的手术疗效。方法：全麻气管双腔插管下用一细长注射针头抽吸医用OB胶适量经胸腔镜操作孔对肺大疱进行腔内注射或切开表面喷涂法来粘闭肺大疱和根治自发性气胸。结果：全组26例全部治愈出院，平均随访达12个月，均元气胸复发。结论：朋腔镜联合医用OB胶肺大疱腔内注射或喷涂是完全有效的，能较多地保留肺组织，既安全又节省手术成本，尤其适用于多发性肺大疱的手术治疗。     

Pneumatoceles in pediatric blunt trauma: Common and benign

Introduction

Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance.

Intracerebral pneumatocele: An unusual complication following intraventricular drainage in a case of benign intracranial hypertension

Summary The development of an intracerebral pneumatocele following ventricular catheterization for benign intracranial hypertension is described. The importance of skull radiography in the diagnosis of this previously unreported complication ist emphasized. This case demonstrates that air can accumulate without the need to implicate increased pharyngeal pressure, and despite raised intracranial pressure.     

Delayed Progressive Extradural Pneumatocele due to Incomplete Sealing of Opened Mastoid Air Cell after Micro-Vascular Decompression

A case of delayed progressive extradural pneumatocele after microvascular decompression (MVD) is presented. A 60-year-old male underwent MVD for hemifacial spasm; the mastoid air cell was opened and sealed with bone wax during surgery. One month after surgery, the patient complained of tinnitus, and progressive extradural pneumatoceles without cerebrospinal fluid (CSF) leakage was observed. Revision surgery was performed and the opened mastoid air cell was completely sealed with muscle patch and glue. The patient''s symptoms were resolved, with no recurrence of pneumatoceles at 6 month follow up. Progressive extradural pneumatocele without CSF leakage after posterior fossa surgery is a very rare complication. Previous reports and surgical management of this rare complication are discussed.     

Pneumatoceles in postpneumonic empyema: an algorithmic approach

Purpose

The aim of the study was to determine the natural course and select appropriate therapy for pneumatocele (PC) in children with postpneumonic empyema.

Materials and Methods

Records of 134 children treated for postpneumonic empyema between October 1997 and June 2003 were reviewed retrospectively, and 58 (43%) of them were found to have PC. Their chest x-rays and computed tomography scans as well as patient profiles were evaluated to assess the size, location, course, and complications. Clinical course, treatment indications, and results were also reviewed.

Results

The patients were aged from 14 months to 15 years (mean 3.8 years). There were 36 boys and 22 girls. The PC was located on the right hemithorax in 34 patients and on the left in 24. Staphylococcus aureus was the most common isolated infective agent. Of the 58 children, 37 (63.7%) showed complete resolution with improvement of the infection within 2 months. Thirteen PCs had evidences of gradual decrease in size without any indication for invasive approaches, and they resolved completely, with a mean time of 6.1 (ranging from 1-13) months. One tension PC, 3 large PCs (>50% of hemithorax), 1 case with bad tolerance to follow-up, and 2 persistent PCs had no reduction in size on follow-up; a total of 7 patients underwent image-guided catheter drainage procedure, and 5 of them resolved completely. In the last 2 cases, surgical excision was required because of persistent cystic cavity caused by thickened PC wall. One patient whose PC had not been decreasing in size developed findings of severe lung abscess with thickened wall and directly underwent surgery. In none of these patients recurrences or complaints related to PC were noted on their control visits.

Conclusion

Most of these PCs are simple PC and show spontaneous resolution with improvement of the infection within the first 2 months. However, some decrease gradually by time, and close follow-up should be continued in case of complicated PC. Persistent features of chest infection, more than 50% involvement of hemithorax and severe atelectasis, development of broncopleural fistulae (tension PC), and bad tolerance to follow-up remind complicated PC, and they are indications of image-guided catheter drainage procedure. Its failure occurs in PC with thickened wall that does not collapse, as was in our cases with persistent PC and severe infected PC, and thus, this is an indication for surgical excision.     

Orbital pneumatocele

Air in the orbit is usually a result of trauma to the orbit but here we report a case of spontaneously occurring orbital Pneumatocele which followed about of sneezing and clearing of nose. The rare site communication at frontoethmoid junction is highlighted with relevant review of literature.     

Spontaneous pneumatocele during radiation of a giant meningosarcoma

Summary A man, aged 66 years, sustained a pneumatocele after radiotherapy for a frontabasal meningeal sarcoma. There was improvement initially, but a fall was experienced without injury to the head and the condition worsened. X-rays of the skull revealed a pneumatocele which was treated conservatively and disappeared within 4 weeks. The literature on spontaneous pneumatocele is reviewed briefly and the etiology discussed.Presented at the 9th Congress of the European Society of Neuroradiology, Brüssel, 12–13 September 1980.     

Persistent pneumatoceles associated with systemic leukocyte abnormalities

Three patients with leucocyte related immune deficiency developed pneumatoceles during acute bacterial pneumonia. A fourth patient with chronic granulomatous disease of childhood developed persistent lung cysts following pulmonary abscesses. The pneumatoceles persisted without significant change for one year to five years. In 25 immunologically normal patients, pneumatoceles that were associated with acute bacterial pneumonia resolved in 3 weeks to 11 months. Perhaps alterations in leukocytic function and in local inflammatory response result in fibrotic cellular reaction and sequestration of parenchymal air collections, precluding their resorption.