Abstract
A 47-year-old man, who was injured in a collision with a car when he was riding on a motorcycle, received intratracheal intubation because a medical staff belonging to a doctor car found decreased SpO2 and flail chest. CT showed a large traumatic pulmonary pseudocyst in the right upper and lower lung lobes. Ventilator weaning was gradually initiated. However, an enlarged cyst was observed later. When positive pressure ventilation was discontinued before extubation on the fifth hospital day, the patient developed respiratory failure due to massive respiratory tract hemorrhage and underwent pulmonary segmentectomy of the right upper and lower lung lobes. The patient was discharged on the 30th hospital day. Delayed enlarged cysts were thought to be induced by the following factors: the cystic diameter was large because of severe injury; positive pressure ventilation was performed; the site of origin was the subpleural pulmonary parenchyma, which has projected to the outside of the pulmonary parenchyma. It is reported that a traumatic pulmonary pseudocyst is relieved by conservative treatment; however, it is necessary to perform surgery in patients with respiratory failure as a complication associated with delayed respiratory tract hemorrhage.
