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2013, Número 4

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Acta Pediatr Mex 2013; 34 (4)


Enfisema lobar adquirido durante una neumopatía crónica intersticial: Implicaciones quirúrgicas y revisión de la literatura

Sancho-Hernández R, Pérez-Fernández LF, Cuevas-Schacht FJ

Idioma: Español
Referencias bibliográficas: 42
Paginas: 189-195
Archivo PDF: 683.55 Kb.


RESUMEN

El enfisema lobar intersticial adquirido (ELIA), inicialmente descrito en lactantes con displasia broncopulmonar actualmente se reconoce en otras entidades donde se genera un daño como secuela de un proceso inflamatorio o causado por apoyo ventilatorio en un paciente neumópata crónico. El ELIA conduce al deterioro progresivo de la función pulmonar con sobredistensión masiva y compresión del parénquima pulmonar y la desviación mediastinal consecuente en el curso de una neumopatía crónica intersticial. Un estudio clínico y una interpretación radiológica adecuados permiten la selección correcta entre un paciente candidato a biopsia pulmonar para obtener un diagnóstico definitivo y uno que en el curso de un ELIA agregado requiere una lobectomía diagnóstica y terapéutica. Se presentan dos casos de esta entidad y la toma de decisiones diagnósticas y quirúrgicas basadas en los hallazgos pre y transoperatorios.


REFERENCIAS (EN ESTE ARTÍCULO)

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  2. Perez-Fernández LF, Cuevas FJ. Primer Consenso Nacional para el Estudio del Niño con Neumopatía Crónica. Sociedad Mexicana de Neumología y Cirugía de Tórax. Acta Pediatr Méx. 2004;25:193-200.

  3. Rena O, Casadio C. Videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease. Europ J Cardio-Thorac Surg. 1999;16: 624-7.

  4. Rahmanian S, Wood KL. Bronchiolitis obliterans and the risk of pneumothorax after transbronchial biopsy. Respir Med CME. 2010;3:87-9.

  5. Avirama G, Schwartz DS. Transthoracic needle biopsy of lung masses: a survey of techniques. Clin Radiol. 2005;60:370-4.

  6. Yung-Chie Lee, Chen-Tu, Wu PH. Surgical lung biopsy for diffuse pulmonary disease: Experience of 196 patients. J Thorac Cardiovasc Surg. 2005;129:984-90.

  7. Rizwan AQ, Tanveer AA. Does lung biopsy help patients with interstitial lung disease? Europ J Cardio-Thorac Surg. 2002;21:621-6.

  8. Pearson FG, Cooper JD. Open lung biopsy. Thoracic Surgery. 2ª edición. United Sates of America: Churchill Livingstone; 2002. p. 116-9.

  9. Rothenberg SS, Wagner JS. The Safety and Efficacy of Thoracoscopic Lung Biopsy for Diagnosis and Treatment in Infants and Children. J Pediatr Surg. 1996;31:100-4.

  10. Adrian O, Iyenger S. VATS Lung Biopsy in Suspected, Diffuse Interstitial Lung Disease Provides Diagnosis, and Alters Management Strategies. Heart Lung and Circul. 2005;14:90-2.

  11. Stefanutti D, Morais L. Value of open lung biopsy in immunocompromised Children. J Pediatr. 2000;137:165-71.

  12. Leland LF, Kozinetz CA, Rothenberg SS. Diagnostic value of transbronchial, thoracoscopic, and open lung biopsy in immunocompetent children with chronic interstitial lung disease. J Pediatr. 1997;131:565-9.

  13. Temes RT, Joste NE. Lung biopsy: is it necessary? J Thorac Cardiovasc Surg. 1999;118:1097-100.

  14. Yasuhiro K, Hiroyuki T. Acute exacerbation of interstitial pneumonia following surgical lung biopsy. Resp Med. 2006;100:1753-9.

  15. Joo Hun Park, Dong Kwan Kim. Mortality and risk factors for surgical lung biopsy in patients with idiopathic interstitial pneumonia. Europ J Cardio-Thorac Surg. 2007;31:1115-9.

  16. Azizkhan RG, Grimmer DL. Acquired Lobar Emphysema (Overinflation): Clinical and Pathological Evaluation of Infants Requiring Lobectomy. J Pediatr Surg. 1992;27:1145-52.

  17. Martínez LA, Hernández J. Surgery of Acquired Lobar Emphysema in the Neonate. J Pediatr Surg. 1984;19:375-9.

  18. Dickman GL, Short BL. Selective bronchial intubation in the management of unilateral pulmonary interstitial emphysema. Am J Dis Childhood. 1977;131:365.

  19. Wood RE. Clinical applications of ultrathin flexible bronchoscopes. Pediatr Pulmonol. 1995;1:244-8.

  20. Leonidas JC, Moylan FM. Ventilation perfusion scans in neonatal regional pulmonary emphysema complicating ventilator assistance. AJR Am J Roentgenol. 1978;131:243-6.

  21. Pearson FG, Cooper JD. Interstitial Lung Disease. Thoracic Surgery. 2ª edición; United Sates of America: Churchill Livingstone; 2002. p. 662-84.

  22. Mouroux J, Clary-Meinesz C. Efficacy and safety of videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease. Euro J Cardio-thoracic Surg. 1997;11:22-6.

  23. Perez-Fernández LF, Cuevas FJ. Primer Consenso Nacional para el Estudio del Niño con Neumopatía Crónica. Sociedad Mexicana de Neumología y Cirugía de Tórax. Acta Pediatr Méx. 2004;25:193-200.

  24. Rena O, Casadio C. Videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease. Europ J Cardio-Thorac Surg. 1999;16: 624-7.

  25. Rahmanian S, Wood KL. Bronchiolitis obliterans and the risk of pneumothorax after transbronchial biopsy. Respir Med CME. 2010;3:87-9.

  26. Avirama G, Schwartz DS. Transthoracic needle biopsy of lung masses: a survey of techniques. Clin Radiol. 2005;60:370-4.

  27. Yung-Chie Lee, Chen-Tu, Wu PH. Surgical lung biopsy for diffuse pulmonary disease: Experience of 196 patients. J Thorac Cardiovasc Surg. 2005;129:984-90.

  28. Rizwan AQ, Tanveer AA. Does lung biopsy help patients with interstitial lung disease? Europ J Cardio-Thorac Surg. 2002;21:621-6.

  29. Pearson FG, Cooper JD. Open lung biopsy. Thoracic Surgery. 2ª edición. United Sates of America: Churchill Livingstone; 2002. p. 116-9.

  30. Rothenberg SS, Wagner JS. The Safety and Efficacy of Thoracoscopic Lung Biopsy for Diagnosis and Treatment in Infants and Children. J Pediatr Surg. 1996;31:100-4.

  31. Adrian O, Iyenger S. VATS Lung Biopsy in Suspected, Diffuse Interstitial Lung Disease Provides Diagnosis, and Alters Management Strategies. Heart Lung and Circul. 2005;14:90-2.

  32. Stefanutti D, Morais L. Value of open lung biopsy in immunocompromised Children. J Pediatr. 2000;137:165-71.

  33. Leland LF, Kozinetz CA, Rothenberg SS. Diagnostic value of transbronchial, thoracoscopic, and open lung biopsy in immunocompetent children with chronic interstitial lung disease. J Pediatr. 1997;131:565-9.

  34. Temes RT, Joste NE. Lung biopsy: is it necessary? J Thorac Cardiovasc Surg. 1999;118:1097-100.

  35. Yasuhiro K, Hiroyuki T. Acute exacerbation of interstitial pneumonia following surgical lung biopsy. Resp Med. 2006;100:1753-9.

  36. Joo Hun Park, Dong Kwan Kim. Mortality and risk factors for surgical lung biopsy in patients with idiopathic interstitial pneumonia. Europ J Cardio-Thorac Surg. 2007;31:1115-9.

  37. Azizkhan RG, Grimmer DL. Acquired Lobar Emphysema (Overinflation): Clinical and Pathological Evaluation of Infants Requiring Lobectomy. J Pediatr Surg. 1992;27:1145-52.

  38. Martínez LA, Hernández J. Surgery of Acquired Lobar Emphysema in the Neonate. J Pediatr Surg. 1984;19:375-9.

  39. Dickman GL, Short BL. Selective bronchial intubation in the management of unilateral pulmonary interstitial emphysema. Am J Dis Childhood. 1977;131:365.

  40. Wood RE. Clinical applications of ultrathin flexible bronchoscopes. Pediatr Pulmonol. 1995;1:244-8.

  41. Leonidas JC, Moylan FM. Ventilation perfusion scans in neonatal regional pulmonary emphysema complicating ventilator assistance. AJR Am J Roentgenol. 1978;131:243-6.

  42. Pearson FG, Cooper JD. Interstitial Lung Disease. Thoracic Surgery. 2ª edición; United Sates of America: Churchill Livingstone; 2002. p. 662-84.




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