肝切除術後橫膈缺損所引發的膿胸及肺膿瘍

Pleural Empyema and Lung Abscess Caused by Diaphragmatic Defects Following Liver Resection

一位55歲男性病人，因肝癌切除右肝手術後，出現右側膿胸及右下葉肺膿瘍，合併橫膈缺損，轉至本院接受搶救手術。該患者7個月前在另一家醫院接受了剖腹手術、右肝葉切除術和膽囊切除術，以治療14.5公分大小的肝癌。經過右胸腔鏡肋膜剝脫術、右下葉基底段切除術、右橫膈膜兩處缺損修復術以及綠膿桿菌感染抗生素之治療，該患者獲得成功治療。手術標本呈現肺膿瘍和右側膿胸，未見肝癌細胞。術後第14天，他順利出院。

A 55-year-old male patient was referred to our hospital for rescue surgery because of a right pleural empyema and right lower lobe lung abscess caused by diaphragmatic defects following hepatic resection. This patient underwent laparotomy with a right liver lobectomy and cholecystectomy for the treatment of a 14.5 cm hepatoma 7 months prior in another hospital. After referral, he was successfully treated by right thoracoscopic decortication, right lung basal segmentectomies, repair of two diaphragmatic defects, and control of the Pseudomonas aeruginosa infection. The surgical specimens showed a right lower lung abscess and right pleural empyema, without the presence of hepatocellular cancer cells. He was uneventfully discharged on postoperative day 14.