Spontaneous pneumothorax as unusual presenting symptom of COVID-19 pneumonia: surgical management and pathological findings.

Autor: Bellini R; Department of Surgery, General Surgery Division, Vimercate Hospital, Vimercate, Italy., Salandini MC; Department of Surgery, General Surgery Division, Vimercate Hospital, Vimercate, Italy. mariachiara.salandini@asst-vimercate.it., Cuttin S; Department of Pathology, Vimercate Hospital, Vimercate, Italy., Mauro S; Milan Study University, Milan, Italy., Scarpazza P; Department of Pneumology, Vimercate Hospital, Vimercate, Italy., Cotsoglou C; Department of Surgery, General Surgery Division, Vimercate Hospital, Vimercate, Italy.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic surgery [J Cardiothorac Surg] 2020 Oct 12; Vol. 15 (1), pp. 310. Date of Electronic Publication: 2020 Oct 12.
DOI: 10.1186/s13019-020-01343-4
Abstrakt: Background: Spontaneous pneumothorax has been reported as a possibile complication of novel coronavirus associated pneumonia (COVID-19). We report two cases of COVID-19 patients who developed spontaeous and recurrent pneumothorax as a presenting symptom, treated with surgical procedure. An insight on pathological finding is given.
Case Presentation: Two patients presented to our hospital with spontaneous pneumothorax associated with Sars-Cov2 infection onset. After initial conservative treatment with chest drain, both patients had a recurrence of pneumothorax during COVI-19 disease, contralateral (patient 1) or ipsilateral (patient 2) and therefore underwent lung surgery with thoracoscopy and bullectomy. Intraoperative findings of COVID-19 pneumonia were parenchymal atelectasis and vascular congestion. Lung tissue was very frail and prone to bleeding. Histological examination showed interstitial infiltration of lymphocytes and plasma cells, as seen in non specific interstitial pneumonia, together with myo-intimal thicknening of vessels with blood extravasation and microthrombi.
Conclusions: Although rarely, COVID-19 may present with spontaneous pneumothorax. Lung surgery for pneumothorax in COVID-19 patients can be safely and effectively performed when necessary.
Databáze: MEDLINE
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