Журнал «Здоровье ребенка» 6 (49) 2013

Bullous emphysema (BEP) is considered the emphysema is characterized by destruction of alveolar walls to form cavities larger than 1.0 cm, which are called bullae. The disease appears as BEL. At the same time, the same authors release this pathology as an independent nosological form, and call it a bullous disease. There are a number of theories to explain the nature of a BEP: genetic, obstructive, mechanical, infectious, vascular, and others. Some scholars consider the BEP and spontaneous pneumothorax (SP) in children as an expression of connective tissue dysplasia (CTD) and effect of magnesium deficiency. CTD - a genetically determined condition caused by impaired metabolism of connective tissue in the embryonic and postnatal periods, particularly when micronutrient deficiency, especially magnesium. The syndrome of the CTD is characterized by abnormalities structure of extracellular matrix components (fibers and ground substance) with morphological and functional changes in various organs and systems.

Here is their own observation. N. child 17 years was in the thoracic separated lenii regional hospital in Donetsk in the middle of December 2012, a local bullous emphysema upper lobes of the lungs, recurrent (on the right in 2010.) Intermittent (left in 2011 ) pneumothorax on the right. Entered the department with complaints of pain in the chest on the right, wheezing, shortness of breath, a feeling of incompleteness of breath, cough. Before enrolling in an hour noted pain in the chest, full of health. Apply to the surgeon, is hospitalized in urgent order.

From the history of life: a child from II pregnancy, flowed with the threat of interruption in five weeks, the mother lying on the conservation. Birth weight 3400 g, length - 52 cm, head circumference - 35 cm. Childbirth first, urgent, complicated by premature of amniotic fluid and kefalogematomy. At 2 years suffered obstructive bronchitis. Each year acute respiratory deseases - up to 3-4 times a year, followed up by allergist and laryngologist doctor on rotation do allergosis respiratory, allergic rhinitis, chronic tonsillitis. At age 7 - sided top part community-acquired pneumonia, at 11 and 12 years-right and left-handed top part pneumonia, respectively. At 9 years of bronchial asthma, identified household and pollen allergy, hay fever, dysplastic car-diopatiya, keeled chest deformity, kyphoscoliosis, prolapse of the mitral valve (according to echocardiography).

Medical history: twice previously had been treated in the thoracic compartment. The first time admitted to the age of 14 right pneumothorax, which developed after exercise. Perform a transaction: thoracentesis sprites Islands, thoracoscopy, thoracostomy. In S1 revealed small bull on the background of fibrosis. Local bullous emphysema diagnosed right upper lobe, right-sided pneumothorax. A year later (in 15 years) hospitalized repeatedly over an intermittent left pneumothorax. On radiographs of the chest in the upper left lung picture is not clear. Produced thoracotsentez, draining the left pleural cavity. The control radiographs "straightened both lungs, the liquid and gas in the pleural cavity were not detected."

Last deterioration occurred in December 2012, 5 months after the exacerbation of the previous, repeated sudden sharp pain in the chest on the right, there was a shortness of breath. Hospitalized repeatedly performed a transaction: Videoassisted minitorakotomiya right, atypical resection of the upper lobe of the right lung bullae, drainage of the pleural cavity. The control radiograph, "both lungs straightened, liquids, gases in the pleural cavity is not. Small right apical pleural layers. In the right upper lobe of the chain of tantalum clips. In other parts of the lung pathologies are no shadows. Heart no change". After discharge from the surgical department of pulmonology transferred to the children's department, where he received a prophylactic treatment for asthma, Magne B6. Present condition of the patient is satisfactory, there is a surgeon and pulmonologist observed.

Summary, early detection of BEL, adequate surgical treatment of developing the joint venture, a basic routine and preventive treatment of asthma in this patient led to a sustained improvement of his health, to prevent BEL transition from a local to a generalized form and in the end allowed ver-nut patient to complete life. Along with this, the use of magnesium products as a means of pathogenetic treatment of connective tissue dysplasia syndrome can significantly improve the quality of life in adulthood.