先天性肺囊肿囊内出血合并感染1例

先天性肺囊肿囊内出血合并感染少见，易误诊。1例14岁男性患儿，因“发热1周，右侧胸痛、痰中带血5 d”入院，外院诊断为“胸腔积液查因”，行胸腔闭式引流，引流出血性混浊液体，经抗感染、胸腔冲洗及胸腔镜治疗后仍有发热，并腔内活动性出血，行血管造影及血管栓塞后无效，紧急开胸手术，术后病理证实为先天性肺囊肿并囊内出血合并感染。先天性肺囊肿囊内出血合并感染的影像学特征极易与胸膜腔内出血相混淆，有创操作又增加其影像学鉴别难度，因此临床医生对患者初诊影像资料应高度重视。

Congenital intracapsular hemorrhage of pulmonary cyst complicated with infection: A case report

Congenital pulmonary cyst is a common benign disease in the lung, but intracapsular hemorrhage combined with infection is rare, which is easy to be misdiagnosed. A 14-year-old male patient presented fever for one week and companied with right chest pain and blood in sputum for 5 days. The external hospital diagnosed the disease as “the cause of pleural effusion” which the patient still had fever and intraluminal active hemorrhage after performing closed drainage of pleural cavity, draining haemorrhagic fluid, and the treatment of anti-infection, thoracic irrigation, and thoracoscope. Because of no effect after angiography and vascular embolization treatment, emergency thoracotomy was performed. Postoperative pathology proved it to be congenital pulmonary cyst with intracapsular hemorrhage and infection. Intracapsular hemorrhage in congenital pulmonary cyst with infection is easy to be confused with intrapleural hemorrhage in imaging. What’s more, invasive operation will increase the difficulty in imaging differentiation. Clinicians should pay a great attention to the initial images of patients.