Misdiagnosis of Swyer-James-Macleod Syndrome as Pulmonary Embolism Leading to a Complication of Extrapulmonary and Rectus Sheath Hematomas-A Case Report

將Swyer-James-Macleod Syndrome誤診爲肺栓塞以致造成肺外及腹直肌內血腫的併發症－一病例報告

劉宜讓(I-Jang Liu) ； 李錦中(Kam-Chung Lee) ； 李俊德(Jiunn-Der Lee) ； 李琳(David-Lin Lee) ； 陶宏洋(Hung-Yang Tao)

《胸腔醫學》 21卷6期 (2006/12) Pp. 506-511

https://doi.org/10.29806/TM.200612.0005

摘要

Swyer-James-Macleod Syndrome症候群是單側高透亮性肺野的其中原因之一。它被認爲是在幼童早期時，遭受下呼吸道感染之後所形成的阻塞性細支氣管炎(bronchiolitis obliterans)。它主要是尚一個單側高透亮性、貧乏血流供應、以及通氣量減低的受損肺葉所組成；偶爾也會合併支氣管擴張症。我們報告一位患有Swyer-James-Macleod Syndrome症候群的61歲女性病人，被其他醫院的心臟血管外科醫師誤診爲肺動脈栓塞而服用抗凝血劑，以至產生咳血及肺外血腫的併發症。我們並且回顧有關胸部X光片呈現單側高透亮性肺野時的鑑別診斷。

關鍵字

阻塞性細支氣管炎bronchiolitis obliterans ； Macleod's症候群 ； 肺栓塞 ； Swyer-James症候群 ； 單側高透亮性肺野

並列摘要

The Swyer-James-Macleod syndrome is one of the causes of unilateral hyperlucent lung. It is thought to be a post-infective form of bronchiolitis obliterans following a lower respiratory tract infection in early childhood. It is comprised principally of hyperlucency, a deficient blood supply, and decreased ventilation in the affected lung, and is sometimes associated with focal bronchiectasis. We present the case of a 61-year-old woman afflicted with Swyer-James-Macleod syndrome that was misdiagnosed as a pulmonary embolism by a cardiovascular surgeon in another hospital. Hemoptysis and severe extrapulmonary hematoma occurred after treatment with anti-coagulants. The literature concerning the differential diagnosis of unilateral hyperlucency on chest X-ray is also reviewed.

並列關鍵字

bronchiolitis obliterans ； Macleod's syndrome ； pulmonary embolism ； Swyer-James syndrome ； unilateral hyperlucent lung