Otvorena dekortikacija pleure kod novorođenčeta uzrasta 12 dana sa empijemom

  • Biljana Medjo University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Dragana Vujović University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Marina Atanasković-Marković University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Marija Karličić University Children’s Hospital, Belgrade, Serbia
  • Tijana Radović University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Dimitrije Nikolić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP220205096M
Ključne reči: dijagnoza, novorođenče, empijem, pleuralni, sepsa, hirurgija, torakalna, procedure, tomografija, kompjuterizovana, rendgenska

Sažetak


Uvod. Empijem pleure, definisan kao prisustvo gnoja u pleuralnom prostoru, retko se javlja u neonatalnom uzrastu. Ne postoji mnogo podataka u medicinskoj literaturi, kao ni smernica za lečenje u toj uzrasnoj grupi. Prikaz bolesnika. Prikazujemo zdravo terminsko novorođenče uzrasta 12 dana, koje je razvilo sepsu izazvanu meticilin rezistentnom bakterijom Staphylococcus aureus (MRSA) i pneumoniju, udruženu sa kasnim stadijumom empijema pleure. Dete je primljeno u bolnicu zbog otežanog disanja i letargije, koji su se javili nekoliko sati pre prijema u bolnicu. Na prijemu u bolnicu novorođenče je bilo cijanotično, u teškom respiratornom distresu, zbog čega je odmah intubirano i započeta je mehanička ventilacija. Hitno su sprovedena radiološka ispitivanja i urađena je kompjuterizovana tomografija (KT) grudnog koša bez kontrasta. Zbog sumnje na kongenitalnu malformaciju disajnih puteva sa „zarobljenom“ kolekcijom vazduha, značajnog pomeranja medijastinuma viđenog na snimku KT, kao i zbog pogoršanja stanja deteta, sprovedena je hitna hiruška intervencija. Intraoperativno je dijagnostikovan empijem pleure drugog stadijuma i učinjena je dekortikacija parijetalne i visceralne pleure. Novorođenče se brzo oporavilo nakon intervencije. Zaključak. Dijagnoza i lečenje empijema kod novorođenčeta mogu predstavljati izazov, posebno u slučaju nejasne anamneze, fulminantne progresije bolesti i nekompletnog radiološkog ispitivanja.

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Objavljeno
2023/08/01
Broj časopisa
Vol. 80 Br. 07 (2023): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika