胸腔鏡下手術を施行した特発性血気胸の2例

Two Cases of Spontaneous Hemopneumothorax Operated with Thoracoscopy

　特発性血気胸の2例に対し，胸腔鏡下に手術を施行した．【症例1】27歳，男性．肺尖に嚢胞を認め，胸壁との間に存在した索状物が離断し，胸壁側，嚢胞側のそれぞれから出血していた．【症例2】41歳，男性．肺尖に索状癒着を認め，索状物の壁側，臓側がそれぞれ裂けて出血していたが，気漏の原因となった嚢胞は縦隔側の別の部位に存在していた．胸腔鏡下手術は特発性血気胸の治療に有用と考えられたが，出血，気漏の原因は同一部位とは限らず，十分に胸腔内全体の観察・検索をする必要があると考えられた．

We have experienced two cases of spontaneous hemopneumothorax which underwent emergency operation using thoracoscopy. In both cases, we found bleeding from ruptured stringy structures between the parietal pleura and the apex of the upper lobe. Those contained vessels, so we suspected that they ruptured when the lung collapsed. In case 1, we found the ruptured stringy structure and bulla on the same point of the lung, while in case 2 the causes of bleeding and air leakage existed separately.