Ulus Travma Acil Cerrahi Derg. 2018; 24(1): 49-55 | DOI: 10.5505/tjtes.2017.56023

Travmatik pulmoner psödokistlerde klinik özellikler, taný ve tedavi yöntemleri

Seray Hazer¹, Umut Perçem Orhan Söylemez^2
1Atatürk Göðüs Hastalýklarý Ve Göðüs Cerrahisi Eðitim Araþtýrma Hastanesi, Göðüs Cerrahisi Kliniði, Ankara
²Bingöl Devlet Hastanesi, Radyoloji Kliniði, Bingöl

AMAÇ: Travmatik pulmoner psödokistler künt göðüs travmalarýnýn nadir komplikasyonlarýdýr. Çalýþmamýzýn amacý, bu nadir durumun komplikasyonlarýndan kaçýnmak ve doðru tedavi yaklaþýmýný tespit etmek üzere 15 olgunun radyolojik ve klinik parametrelerle deðerlendirilmesidir.
GEREÇ VE YÖNTEM: Temmuz 2014–Aralýk 2015 tarihleri arasýnda kliniðimizde toraks travmasý nedeniyle takip edilen 185 hastanýn bilgileri ve radyolojik görüntüleri geriye dönük olarak deðerlendirildi.
BULGULAR: Travmatik pulmoner psödokist tespit edilen 15 hastanýn klinik özellikleri ve görüntüleme bulgularý deðerlendirildi. Ortalama yaþ 26.33’dü (1–89 yaþ). On üç olguda etiyolojide trafik kazasý sorumlu iken iki olguda yüksekten düþme sonrasý geliþmiþti. Beþ olguda tüp torakostomi uygulandý. Olgularýn %66’sý komplikasyonsuz iyileþti ve hiçbir olguda torakotomi gereksinimi olmadý. Beþ olgu, eþlik eden toraks dýþý ciddi yaralanmaya baðlý olarak kaybedildi.
TARTIÞMA: Pnömotosel formasyonu akciðer parankiminde meydana gelen ani makaslama gücü etkisiyle parankimde kontüzyon geliþmesi ve kontüzyon alanýndan ani hava çýkýþýyla oluþmaktadýr. Bu hastalarda önerilen tedavi yaklaþýmý konservatif olmakla birlikte kist rüptürüne baðlý komplikasyonlar geliþebilir. Hastalar yakýn takip edilmelidirler ve hayatý tehdit eden komplikasyonlar açýsýndan dikkatli olunmalýdýr.

Anahtar Kelimeler: Bilgisayarlý tomografi, künt göðüs travmasý; pnömotosel; travmatik pulmoner psödokist

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Clinical features, diagnosis, and treatment of traumatic pulmonary pseudocysts

Seray Hazer¹, Umut Perçem Orhan Söylemez^2
1Department of Thoracic Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara-Turkey
²Department of Radiology, Bingol State Hospital, Bingol-Turkey

BACKGROUND: Traumatic pulmonary pseudocysts (TPP) are rare complications of blunt chest trauma. The aim of this study is to increase the understanding of this rare entity with imaging and clinical parameters for preventing complications and determining the correct treatment approach by observing 15 cases.
METHODS: We retrospectively reviewed the medical data and thoracic computed tomography scans of 185 patients who underwent examinations in our department after chest trauma between July 2014 and December 2015.
RESULTS: Fifteen patients had TPPs, and their clinical features and imaging findings were evaluated. Their average age was 26.33 (range, 1–89) years. The cause of TPP was traffic accident in 13 patients and falling from a height in two. Tube thoracostomy was required in five patients. None of the patients required thoracotomy, and 66% of them recovered without any complications. Five patients died because of serious concomitant injuries.
CONCLUSION: Sudden shearing force across the pulmonary parenchyma results in an area of pulmonary contusion and airtransfer from the airway to the contused area, which in turn leads to pneumatocele formation. Conservative treatment is recommended for these patients, but complications can occur because of cyst rupture. Patients should be closely monitored and be made aware of the risk of life-threatening complications.

Keywords: Blunt chest trauma, computed tomography; pneumatocele; traumatic pulmonary pseudocyst.

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