瘻孔同定に気腹が有用であった横隔膜交通症

Usefulness of Insufflation into the Abdominal Cavity for Repair of Pleuroperitoneal Communication

われわれは肝性胸水を伴う横隔膜交通症に対し，胸腔鏡下に瘻孔を同定し閉鎖することで胸水をコントロールしえた症例を経験したので報告する．

The patient is an 86-year-old woman. She had ascites and was being treated with diuretics, but developed dyspnea, so a chest computed tomography （CT） scan was performed which revealed right pleural effusion. After aspiration of pleural effusion, abdominal distention due to ascites decreased and video-assisted thoracoscopic surgery was performed on suspicion of pleuroperitoneal communication. The diaphragm was sutured using an automatic suture device because a hole was found in the diaphragm. Insufflation into the abdominal cavity technique was safety and useful for identifying pleuroperitoneal communication.