肺区域切除後急速に出現した肺囊胞による気胸

Rapidly Developing Pulmonary Cyst Complicated by Pneumothorax Occurred in the Early Post-operative Period after Lung Segmentectomy

術後気胸は肺切除後の一般的な合併症であるが，手術操作部位やその近傍から気漏が生じることが多い．われわれは，肺区域切除後に手術操作部位とはかけ離れた部位においてブラが急速に成長し，気胸を生じた症例を経験したので，若干の考察を加えて報告する．

The patient was a 74-year-old man who had undergone surgery for rectal cancer 9 years before and had developed left lung metastasis（S3）3 years and 4 months prior to admission. He had received video assisted left lung wedge resection. He presented with a growing nodular lesion close to the remaining left lung margin and elevated serum carcinoembryonic antigen（CEA）levels, and underwent open extended segmentectomy. The chest drain tube was removed on 3rd post-operative day, but he developed left pneumothorax on 4th post-operative day and a computed tomography（CT）scan revealed a cystic lesion 5.0 cm in size at the base of his left lung. Revision surgery was performed on 8th post-operative day. A pulmonary cyst on the diaphragmatic surface of the lung（S10）was found and location of the air leak was confirmed in the same area. Following wedge resection of the cyst-containing region, the leak ceased completely.

Rapid manifestation of a newly formed pulmonary cyst during the acute post-operative period is rare.