근육 내 자극 요법 후 발생한 의인성 기흉 2예

Two Cases of Iatrogenic Pneumothorax after Intra-Muscular Stimulation (IMS) Therapy

  • 손준광 (서남대학교 의과대학 내과학교실) ;
  • 오인재 (전남대학교 의과대학 내과학교실) ;
  • 정종필 (전남대학교 의과대학 내과학교실) ;
  • 김수옥 (전남대학교 의과대학 내과학교실) ;
  • 주진영 (전남대학교 의과대학 내과학교실) ;
  • 임정환 (전남대학교 의과대학 내과학교실) ;
  • 조계중 (전남대학교 의과대학 내과학교실) ;
  • 채동렬 (전남대학교 의과대학 내과학교실) ;
  • 김규식 (전남대학교 의과대학 내과학교실) ;
  • 김유일 (전남대학교 의과대학 내과학교실) ;
  • 임성철 (전남대학교 의과대학 내과학교실) ;
  • 김영철 (전남대학교 의과대학 내과학교실)
  • Son, Jun Gwang (Department of Internal Medicine, Seonam University Medical School) ;
  • Oh, In Jae (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Jeong, Jong Pil (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Soo Ok (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Ju, Jin Yung (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Lim, Jung Hwan (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Cho, Gye Jung (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Chae, Dong Ryeol (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Kyu Sik (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Yu Il (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Lim, Sung Chul (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Young Chul (Department of Internal Medicine, Chonnam National University Medical School)
  • 투고 : 2007.09.10
  • 심사 : 2007.10.22
  • 발행 : 2007.11.30

초록

저자 등은 대학 병원 응급실을 내원한 2명의 환자에서 근육내 자극 요법 후 부작용으로 발생한 의인성 기흉의 증례를 경험하였기에 보고하는 바이다.

Recently, intra-Muscular Stimulation (IMS) therapy is being increasingly used for musculoskeletal pain. This procedure is generally regarded as a safe procedure for the general public. Some cases of iatrogenic pneumothorax caused by acupuncture have been reported in the medical literature. However, a case of an IMS therapy associated pneumothorax has not reported. We experienced two cases of iatrogenic pneumothorax after IMS therapy. A 62 year-old man received IMS therapy on the right shoulder due to posterior neck pain. After IMS therapy, acute dyspnea and chest discomfort developed. The other patient was a 74 year-old woman who also received IMS therapy. This patient experienced a nonproductive cough and acute dyspnea after the treatment. As the popularity of this form of alternative medicine increases, we might expect to see more cases of iatrogenic pneumothorax. Physicians should be aware of the adverse events associated with IMS therapy.

키워드

참고문헌

  1. Richard WL. Pneumothorax. In: John FM, Jay A Nadel, editors. Textbook of respiratory medicine. 2nd ed. Philadelphia: Saunders; 1998. p. 2193-210
  2. Despars JA, Sassoon CS, Light RW. Significance of iatrogenic pneumothoraces. Chest 1994;105:1147-50 https://doi.org/10.1378/chest.105.4.1147
  3. Berger R. Iatrogenous pneumothorax. Chest 1994;105:980-2 https://doi.org/10.1378/chest.105.4.980
  4. Melton LJ 3rd, Hepper NG, Offord KP. Incidence of spnontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974. Am Rev Respir Dis 1979;120: 1379-82
  5. Eo EK, Shin JS, Choi OK. Pneumothorax following by acupuncture. J Korean Soc Emerg Med 1996;7:429-33
  6. Gunn CC. The Gunn approach to the treatment of chronic pain. Seoul: Koonja; 2000. p.3-29
  7. Gunn CC. Neuropathic pain: a new theory for chronic pain of intrinsic origin. Ann R Coll Physicians Surg Can 1989;22:327-30
  8. Bonica JJ. The management of pain. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 522-9
  9. Levy H, Kallenbach JM, Feldman C, Pincus P, Hurwitz M. Edlayed pneumothorax after transbronchial lung biopsy. Thorax 1986;41:647-8 https://doi.org/10.1136/thx.41.8.647
  10. Plaus WJ. Delayed pneumothorax after subclavian vein catheterization. JPEN J Parenter Enteral Nutr 1990;14: 414-5 https://doi.org/10.1177/0148607190014004414
  11. Kircher LT Jr, Swartzel RL. Spontaneous pneumothorax and its treatment. JAMA 1954;155:24-9 https://doi.org/10.1001/jama.1954.03690190030009
  12. Chernick V, Avery ME. Spontaneous alveolar rupture at birth. Pediatrics 1963;32:816-24
  13. Roggla M, Wagner A, Brunner C, Roggla G. The management of pneumothorax with the thoracic vent versus conventional intercostals tube drainage. Wien Klin Wochenschr 1996;108:330-3
  14. Pancione L. The treatment of iatrogenic pneumothorax with small-gauge catheters. The author's personal experience in 30 cases. Radiol Med (Torino) 2000;100: 42-7