A deep azygoesophageal recess may increase the risk of secondary spontaneous pneumothorax

作者：Takahashi Tsuyoshi^*; Kawashima Mitsuaki; Kuwano Hideki; Nagayama Kazuhiro; Nitadori Jyunichi; Anraku Masaki; Sato Masaaki; Murakawa Tomohiro; Nakajima Jun

来源：Surgery Today, 2017, 47(9): 1147-1152.

DOI：10.1007/s00595-017-1482-1

• Emphysema/bullae
• Mediastinum pneumothorax

Purpose The azygoesophageal recess (AER) is known as a possible cause of bulla formation in patients with spontaneous pneumothorax. However, there has been little focus on the depth of the AER. We evaluated the relationship between the depth of the AER and pneumothorax development.
Methods We conducted a retrospective study of 80 spontaneous pneumothorax patients who underwent surgery at our institution. We evaluated the depth of the AER on preoperative computed tomography scans.
Results Ruptured bullae at the AER were found in 12 patients (52.2%) with secondary spontaneous pneumothorax (SSP) and 8 patients (14.0%) with primary spontaneous pneumothorax (PSP) (p < 0.001). In patients with ruptured bullae at the AER, 10 SSP patients (83.3%) had a deep AER while only 2 PSP patients (25%) had a deep AER (p = 0.015).
Conclusion A deep AER was more frequently associated with SSP than with PSP. A deep AER may contributes to bulla formation and rupture in SSP patients.

• 出版日期2017-9