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Incidentally Detected Pericardial Defect in a Patient with Pneumothorax as Confirmed on Video-Assisted Thoracoscopic Surgery

흉강경 수술로 확인한 우연히 발견된 기흉을 동반한 심막결손

  • Hyunwoo Cho (Department of Radiology, Dong-A University Medical Center, Dong-A University College of Medicine) ;
  • Eun-Ju Kang (Department of Radiology, Dong-A University Medical Center, Dong-A University College of Medicine) ;
  • Moon Sung Kim (Department of Radiology, Dong-A University Medical Center, Dong-A University College of Medicine) ;
  • Sangseok Jeong (Department of Cardiothoracic Surgery, Dong-A University Medical Center, Dong-A University College of Medicine) ;
  • Ki-Nam Lee (Department of Radiology, Dong-A University Medical Center, Dong-A University College of Medicine)
  • 조현우 (동아대학교 의과대학 동아대학교의료원 영상의학과) ;
  • 강은주 (동아대학교 의과대학 동아대학교의료원 영상의학과) ;
  • 김문성 (동아대학교 의과대학 동아대학교의료원 영상의학과) ;
  • 정상석 (동아대학교 의과대학 동아대학교의료원 흉부외과) ;
  • 이기남 (동아대학교 의과대학 동아대학교의료원 영상의학과)
  • Received : 2020.03.26
  • Accepted : 2020.07.03
  • Published : 2021.05.01

Abstract

Congenital defects of the pericardium, which are generally asymptomatic, are rare disorders characterized by complete or partial absence of the pericardium. Here, we report a rare case of a 19-year-old male who was incidentally diagnosed with congenital absence of the left pericardium during examination for symptoms of pneumothorax. Chest radiography and CT revealed a collapsed left lung without any evidence of trauma, no unusual findings of free air spaces along the right side of the ascending aorta, heart shifted toward the left side of the thorax, and a shallow chest. Subsequent thoracoscopy confirmed the absence of the left pericardium and displacement of the heart toward the left thoracic cavity. We further discuss the correlation between radiologic images and surgical findings of a congenital pericardial defect associated with spontaneous pneumothorax.

선천성 심막결손은 대부분의 환자가 무증상을 보이는 드문 질환으로 전체 혹은 부분 심막결손으로 나타난다. 본 논문에서는 기흉 증상으로 인해 우연히 좌측 선천성 심막결손을 진단받은 19세 남성 환자를 보고하고자 한다. 일반 흉부 X선 사진 및 컴퓨터단층촬영에서 외상의 흔적이 없는 무기폐, 상행대동맥의 우측에 비정상적으로 위치한 공기, 좌측 흉부로 전위된 심장, 그리고 납작한 흉곽이 보였다. 뒤이은 흉강경검사에서 좌측 심막결손과 왼쪽 흉강으로의 심장 전위가 확인되었다. 이는 영상의학적 소견과 수술적 소견이 잘 일치하는 자발성 기흉이 동반된 선천성 심막결손에 관한 보고이다.

Keywords

References

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