Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Tracheostomy Induced Bilateral Tension Pneumothorax

급성호흡부전 환자에서 기관절개술 시술 후에 발생한 양측성 긴장성 기흉 1예

  • Yoon, Hyeon Young (Departments of Internal Medicine, Hallym University College of Medicine) ;
  • Oh, Suk Ui (Departments of Internal Medicine, Hallym University College of Medicine) ;
  • Park, Jong Gyu (Departments of Internal Medicine, Hallym University College of Medicine) ;
  • Sin, Tae Rim (Departments of Internal Medicine, Hallym University College of Medicine) ;
  • Park, Sang Myeon (Departments of Internal Medicine, Hallym University College of Medicine)
  • 윤현영 (한림대학교 의과대학 내과학교실) ;
  • 오숙의 (한림대학교 의과대학 내과학교실) ;
  • 박종규 (한림대학교 의과대학 내과학교실) ;
  • 신태림 (한림대학교 의과대학 내과학교실) ;
  • 박상면 (한림대학교 의과대학 내과학교실)
  • Received : 2007.03.26
  • Accepted : 2007.05.04
  • Published : 2007.05.30
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Abstract

Tracheostomy is one of the oldest surgical procedures in medical history. The indications for a tracheostomy include the relief of an upper airway obstruction, long-term mechanical ventilation, and decreased airway resistance to help wean the patient from mechanical ventilator support. Unfortunately, tracheostomy is also associated with a number of problems including, bleeding, infection, pneumothorax, and tracheal stenosis. A pneumothorax is an uncommon complication of a tracheostomy, and can result from direct injury to the pleura or positive pressure ventilation through a dislocation of the tracheostomy tube. We report an uncommon case of a tracheostomy-induced bilateral tension pneumothorax with a review of the literature.

기관절개술은 가장 오래된 수술기술 중의 하나로 상기도 폐쇄의 경감, 장기간의 기계호흡유지, 보조적 기계호흡시에 기도 저항의 감소 등의 목적으로 시행할 수 있다. 기관절개술에 따른 초기합병증으로는 기흉, 피하조직기종, 절개부위 출혈, 종격동 기종, 흡인, 기관절개 관 전위 등을 들 수 있다. 수술에 따른 피하조직기종과 기흉은 0.9-5%에서 보고되었다. 본 증례에서는 기관절개술 직후에 피하조직기종과 양측 폐에서 발생한 긴장성 기흉을 경험하였기에 보고하는 바이다.

Keywords

References

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