A Rare Case of Tubercular Pyo– Pneumothorax Herniating through the Inter-Costal Drainage Site
| Autor: | Swapna Ponmaleri Koroth, Peter George, Maroli Roshan |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Lateral chest wall
medicine.medical_specialty business.industry lcsh:R Clinical Biochemistry Axillary lines lcsh:Medicine General Medicine Dehiscence Images in Medicine medicine.disease Left sided pyo-pneumothorax Surgery herniation medicine.anatomical_structure tuberculosis Pneumothorax Rare case intercostal drainage site Computer tomographic Medicine Intercostal space business |
| Zdroj: | Journal of Clinical and Diagnostic Research, Vol 7, Iss 7, p 1535 (2013) |
| ISSN: | 2249-782X |
| DOI: | 10.7860/jcdr/2013/5427.3182 |
| Popis: | A 53 year old diabetic male, who was on anti – tubercular treatment, presented with an expansile swelling on his chest, at the intercostal drainage (ICD) site. He was diagnosed to have a left sided tubercular hydro – pneumothorax, about six weeks earlier. He had noticed the swelling at the ICD site, 5 days ago and he had no pain. Clinically, an expansile swelling of size 5 x 4 cm, was seen at the 6th ICS, in the mid axillary line, which was partially reducible, with palpable crepitations [Table/Fig-1]. The left hemi – thorax showed reduced movements and breath sounds. Contrast enhanced computer tomographic (CECT) images of thorax showed left upper lobe consolidation, with cavities and a hydro – pneumothorax. The left pleural space was seen to extend through the dehiscence on lateral chest wall, forming an air – filled subcutaneous swelling. [Table/Fig-2]. Anti-tubercular therapy was continued and a fresh ICD was inserted at the lower intercostal space, which drained the purulent fluid. After a week, repair and layered suturing was done at the site of dehiscence. The wounds approximated and healed over the next 3 – 4 weeks. A pyo-pneumothorax which is caused by tuberculosis is common in endemic areas [1]. There is one report in the literature on herniation of an emphysematous bulla through an ICD site [2]. However, herniation of a pyo-pneumothorax through a closed ICD site was not found in our literature review. |
| Databáze: | OpenAIRE |
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