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Article in Japanese
Abstract
Case Report
A case of refractory pneumothorax after partial resection for a rheumatoid lung nodule
Arisa Hamadaa,* Mineyo Mitoa Yoshihiro Kitaharaa Kikuo Nakanoa Takeshi Mimurab Yoshinori Yamashitab
aDepartment of Respiratory Internal Medicine, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
bDepartment of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
*Present address: Department of Respiratory Medicine, Hiroshima University Hospital
ABSTRACT
A 37-year-old man was diagnosed with rheumatoid arthritis, and had been treated with methotrexate, steroid, and biologics. In April 2018, a mass in the left lower lobe of the lung was detected during a medical examination; he subsequently underwent thoracoscopic partial resection of the left lower lobe of the lung for definitive diagnosis. Pathological examination revealed rheumatoid lung nodules. Six months after surgery, the patient developed a left-sided pneumothorax. Although lung sutures resulted in recurrence, the patient finally improved following endoscopic bronchial occlusion with an Endobronchial Watanabe Spigot (EWS®). Intraoperative and postoperative management of pneumonectomy in patients with rheumatoid arthritis undergoing treatment with multiple drugs should be carefully monitored, considering the possibility of tissue vulnerability and delayed wound healing due to the drugs.
KEYWORDS
Partial resection of the lung Rheumatoid lung nodule Refractory pneumothorax Bronchial occlusion
Received 19 Mar 2022 ／ Accepted 14 Apr 2022
AJRS, 11(4): 218-222, 2022
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