초록접수 현황
| 14F-012 | 구연 발표 |
Traumatic Pulmonary Pseudocysts: Incidence, Injury Mechanisms and Computed Tomographic Findings
Hyun Jin Cho, Dae Sung Ma, Yang Bin Jeon
Department of Thoracic and Cardiovascular Surgery Gachon University Gil Medical Center
Background : Traumatic pulmonary pseudocyst (TPP) is a rare complication of blunt chest trauma and closely related with severe injuries. However, it has been poorly documented. We present a retrospective review of TPPs observed during the past 4 years in our hospital.
Methods : We retrospectively studied the record of the patients with TPP from January 2010 to December 2013.
Results : A total of 978 patients were performed a computed tomography (CT) of the chest because of blunt chest trauma. Of these, 81 patients (8.3%) had 150 TPPs. The most common injury mechanism in the patients with TPP was a pedestrian traffic accident (n = 25, 30.9%). Mean injury severity score (ISS) was 33.2 ± 11.4. The most commonly involved lobe was right lower lobe (n = 25, 30.9%) and air-fluid pattern was the most common pattern (n = 41, 50.6%). Most of TPPs were in parenchymal contusion (n = 75, 92.6%). Median size of TPPs was 23.0 mm (IQR: 15 ~ 37 mm) and cranio-caudal diameter was the greatest diameter in 52 patients (64.2%). Incidence of TPP was higher in younger patients (p = 0.011) although total number of the fractured ribs was significantly lower in younger patients (p = 0.001). In subgroup analysis according to location of TPP (subpleural (n = 40) vs. intraparenchymal (n = 41)), intraparenchymal group had more severe injuries (ISS: 23.3 ± 9.8 vs. 32.4 ± 12.2, p < 0.001; chest abbreviated injury score: 3.4 ± 0.5 vs. 4.0 ± 7.2, p < 0.001; number of associated injuries: 2.9 ± 1.3 vs. 4.0 ± 1.5, p = 0.001; total number of the fractured ribs: 4.9 ± 4.2 vs. 7.1 ± 5.3, p = 0.05). In multivariate analysis, ISS, age, and number of associated injuries showed significant differences between two groups (p = 0.038, p = 0.006, and p = 0.045, respectively). Closed thoracostomy was performed in 47 patients (58.0%) because of combined hemothorax, pneumothorax, or hemopneumothorax. There were no TPP related complications or interventions. A chest CT was followed in 14 patients and showed resolution of TPPs. Twenty of 49 patients who were in need of mechanical ventilation were due to lung injury. Of these, 3 patients died (3.7%) and all of them had intraparenchymal TPP.
Conclusion : The incidence of TPP in blunt chest trauma was 8.3% and higher in younger patients. Intraparenchymal TPP occurred in patients with more severe injuries or younger patients.
Methods : We retrospectively studied the record of the patients with TPP from January 2010 to December 2013.
Results : A total of 978 patients were performed a computed tomography (CT) of the chest because of blunt chest trauma. Of these, 81 patients (8.3%) had 150 TPPs. The most common injury mechanism in the patients with TPP was a pedestrian traffic accident (n = 25, 30.9%). Mean injury severity score (ISS) was 33.2 ± 11.4. The most commonly involved lobe was right lower lobe (n = 25, 30.9%) and air-fluid pattern was the most common pattern (n = 41, 50.6%). Most of TPPs were in parenchymal contusion (n = 75, 92.6%). Median size of TPPs was 23.0 mm (IQR: 15 ~ 37 mm) and cranio-caudal diameter was the greatest diameter in 52 patients (64.2%). Incidence of TPP was higher in younger patients (p = 0.011) although total number of the fractured ribs was significantly lower in younger patients (p = 0.001). In subgroup analysis according to location of TPP (subpleural (n = 40) vs. intraparenchymal (n = 41)), intraparenchymal group had more severe injuries (ISS: 23.3 ± 9.8 vs. 32.4 ± 12.2, p < 0.001; chest abbreviated injury score: 3.4 ± 0.5 vs. 4.0 ± 7.2, p < 0.001; number of associated injuries: 2.9 ± 1.3 vs. 4.0 ± 1.5, p = 0.001; total number of the fractured ribs: 4.9 ± 4.2 vs. 7.1 ± 5.3, p = 0.05). In multivariate analysis, ISS, age, and number of associated injuries showed significant differences between two groups (p = 0.038, p = 0.006, and p = 0.045, respectively). Closed thoracostomy was performed in 47 patients (58.0%) because of combined hemothorax, pneumothorax, or hemopneumothorax. There were no TPP related complications or interventions. A chest CT was followed in 14 patients and showed resolution of TPPs. Twenty of 49 patients who were in need of mechanical ventilation were due to lung injury. Of these, 3 patients died (3.7%) and all of them had intraparenchymal TPP.
Conclusion : The incidence of TPP in blunt chest trauma was 8.3% and higher in younger patients. Intraparenchymal TPP occurred in patients with more severe injuries or younger patients.
책임저자: Yang Bin Jeon
Department of Thoracic and Cardiovascular Surgery Gachon University Gil Medical Center
연락처 : Hyun Jin Cho, Tel: 032-460-3010 , E-mail : irainy79@naver.com
