肺膿瘍胸腔内穿破に対する遊離皮下脂肪組織を用いた修復

Intrathoracic Perforation of Lung Abscess Repaired with Free Subcutaneous Adipose Tissue

肺膿瘍の胸腔内穿破による膿胸は比較的まれな病態であり，さらに遊離皮下脂肪組織による瘻孔閉鎖の報告は検索しうる限り数少ない．われわれは肺膿瘍胸腔内穿破により発症した膿胸に対して遊離皮下脂肪組織を用いて瘻孔閉鎖を行い，良好な結果を得た1例を経験したので報告する．

We report the usefulness of free subcutaneous adipose tissue for the closure of a fistula in fistulous pyothorax resulting from intrathoracic perforation of a lung abscess. A 52-year-old male was admitted to our medical facility with a diagnosis of lung abscess and pyothorax. A computed tomography （CT） scan revealed a focal pleural defect of the lung abscess, resulting in the diagnosis of fistulous pyothorax. Following transfer to our department, the patient underwent thoracoscopic curettage of the pyothorax cavity, followed by fistula closure. In detail subcutaneous adipose tissue was harvested from the open chest wound and packed into the fistula for the closure of a fistula. While there is limited literature on the closure of fistulas using free subcutaneous adipose tissue in cases of fistulous pyothorax, this technique exhibits potential efficacy as a therapeutic approach.