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Co-Existence of Posttraumatic Empyema Thoracis and Lung Abscess in a Child after Blunt Chest Trauma: A Case Report

兒童胸部鈍傷後併發創傷後膿胸併有肺膿瘍:病例報告

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摘要


創傷後膿胸是胸部創傷後少見的併發症,發生率約1.6-2.4%,在兒童的病例甚為少見。我們報告一位15歲的男孩,發生車禍後一開始被診斷為肺挫傷,但卻在14天後出現高燒,咳嗽合併膿痰及右胸疼痛的症狀。經診斷為創傷後膿胸合併肺膿瘍,我們成功地以電腦斷層掃描定位引流術及抗生素治療病人。我們強調創傷後膿胸合併肺膿瘍在兒童的病例非常少見,臨床醫師對創傷後產生肺挫傷的病人應提高警覺並小心追蹤。雖然文獻報告大部分出現創傷後膿胸的病人都需要外科治療,我們的經驗提供,影像定位引流術在篩選過的病人可作為第一線輔助治療方法。

並列摘要


Posttraumatic empyema is a rare complication of trauma with an incidence of 1.6-2.4% in trauma patients. However, it is rarely reported in children. We report the case of a 15-year-old boy who was involved in a traffic accident and diagnosed with a pulmonary contusion at a local hospital. Fourteen days after the accident, posttraumatic empyema thoracis and lung abscess developed with clinical presentations of fever, productive cough and right chest pain. He was successfully treated with computed tomography-guided catheter drainage and intravenous cefotaxime. We emphasize that posttraumatic empyema thoracis and lung abscess are very rare in children, and careful follow-up for posttraumatic lung contusion is essential. Image-guided catheter drainage can be an adjunctive tool for treating selected patients, although most complicated cases of posttraumatic empyema thoracis require decortication therapy.

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