Year: 2021
Type: conference-abstract
Abstract: Introduction/Description Secondary Spontaneous Pneumothorax has its peak incidence in adulthood, occurring as a complication of an underlying lung disease, with variable symptoms at presentation. A 15-year-old female previously healthy was admitted to the Emergency Department complaining of chest pain on left hemithorax and dyspnoea lasting for 24 hours, associated with a non-productive cough for 1 week. She denied fever, rhinorrhea, trauma, foreign body aspiration, inhalation of drugs, consumption of tobacco or any medication. She had no relevant family history. On admission, she was eupneic, SpO2 99% (FiO2 21%) and an absence of vesicular murmur was noted on the left hemithorax. Chest radiography revealed a left side pneumothorax with no mediastinal deviation. Supplemental oxygen was initiated by a nonrebreathing facemask and the patient was advice to rest. The lack of improvement motivated a pneumothorax drainage by needle aspiration with an initial favourable response. However, 24 hours later a recurrence of the pneumothorax was noted in the control radiography. Chest-CT confirmed this finding and depicted an atelectasis of the left lower lobe, with a slight right deviation of the upper mediastinum and left apical pulmonary cystic features, suggestive of Congenital Cystic Adenomatoid Malformation (CCAM) of the lung. Subsequently, surgical removal of the left upper lobe was performed and CCAM type II was confirmed by histopathology. Conclusion Although primary spontaneous pneumothorax in adolescents is the most common subtype, in cases where the course of the disease is not as expected, a secondary cause should be considered. Even though CCAM is considered a rare disorder, it is the most common congenital pulmonary malformation with an incidence of 1:8300 to 35.000 live-births. CCAM occurs mostly sporadically and in about 1/3 of the cases the diagnosis is made after the neonatal period. In the presence of pneumothorax, CCAM type IV should be considered and deserves special attention due to its malignant potential. In symptomatic cases, the therapeutic measures consist in pulmonary resection of the affected areas, which is curative and has few complications.
Source: Abstracts
Authors: Joana Filipe Ribeiro, Íris Santos Silva, João Virtuoso, Pedro Fernandes, Glória Silva, Rita S Oliveira, Pedro Carvalho
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3205658516