Pericardial cyst and pericardial diverticulum
Introduction
Brief introduction of pericardial cyst and pericardial diverticulum Pericardial cyst refers to a congenital mediastinal cyst that occurs in the pericardium, also known as mesothelial cyst, pericardial cyst, pleural pericardial cyst, mediastinal cyst or mediastinal simple cyst. The cyst is isolated from the pericardial cavity and is called the pericardial diverticulum if it is connected to the pericardial cavity. Most scholars believe that pericardial cysts appear in some gaps in the embryonic head and the mesoderm side plates. If one of these gaps does not fuse with other gaps, it will develop into a pericardial cyst. If some of the fusions have pedicle and pericardium The cavity is connected to form a pericardial diverticulum. basic knowledge The proportion of illness: 0.001% Susceptible people: infants and young children Mode of infection: non-infectious Complications: superior vena cava syndrome
Cause
Pericardial cyst and pericardial diverticulum
(1) Causes of the disease
It is not fully understood. Most scholars believe that the pericardial cyst is in the embryonic stage, and there are some gaps in the embryonic head and the mesoderm side plates. If one of these gaps does not fuse with other gaps, it will develop into a pericardial cyst. If a partial fusion is left in contact with the pericardial cavity, a pericardial diverticulum is formed.
(two) pathogenesis
The lesion can occur in any part of the pericardium, even in the base of the superior mediastinum, but the most common right palpebral angle is the size of the cyst, thin and transparent, the liquid in the capsule is clear like water or light yellow transparent liquid, the amount of liquid is generally Within 30ml, a few can reach 1000ml, its structure is single or multi-atrial wall, the outer wall is loose connective tissue, and the inner wall is a single layer of mesothelium or endothelial cells.
Prevention
Pericardial cyst and pericardial diverticulosis prevention
1. Strengthen publicity and education, promote prenatal and postnatal care; strengthen pregnancy care, guide reasonable pregnancy, and avoid the occurrence of fetal congenital malformations.
2. Reasonable arrangement of exercise should control the amount of exercise.
Complication
Pericardial cyst and pericardial diverticulum complications Complications of superior vena cava syndrome
The superior vena cava syndrome can occur. Incision infection, postoperative intestinal adhesions and pneumonia, etc. It is particularly noted that postoperative intestinal adhesion is a common complication after abdominal surgery, but some cystic cysts have a lower cyst position, the operation will involve the abdominal cavity, so the intestine will also occur. Adhesive clinical abdominal pain as the main symptom, the incidence is very high, severe cases can occur adhesive intestinal obstruction.
Symptom
Pericardial cyst and pericardial diverticulum symptoms Common symptoms Shortness of breath, chest pain, palpitations, chest tightness, heart failure
Most patients have no symptoms, and accidental findings for other various reasons. Only a few patients have symptoms of chest discomfort, such as chest pain, chest tightness or fullness of the chest. If the lesion is more oppressive, palpitations, shortness of breath or heart failure may occur. Performance, some patients may be aggravated by fatigue or body position, and there is no positive finding in the examination. For example, the cyst is located between the ascending aorta and the superior vena cava, and the superior vena cava syndrome may occur.
Examine
Pericardial cyst and pericardial diverticulum examination
1. Chest X-ray examination of pericardial cysts, diverticulum can be expressed as a circular or elliptical shadow from the mediastinum to the lung field, the edges are smooth and clear, the density is light and uniform, no lobulation: a few shell-like calcification, heart edge The cysts showed a "teardrop" appearance, and the lateral slices showed a full shadow.
2. The chest pericardial diverticulum is connected with the pericardial cavity. When the patient takes a deep breath or changes position, the liquid moves back and forth between the diverticulum and the pericardial cavity. Sometimes the size and shape of the tumor are changed under fluoroscopy.
3. Artificial pneumothorax shows that the shadow is not in the lungs and is connected to the pericardium.
4. Pericardial puncture gas is visible in the chamber.
Diagnosis
Diagnosis and differentiation of pericardial cyst and pericardial diverticulum
X-ray examination is of great help to the diagnosis of this disease, and the above performance can be seen. However, due to insufficient attention to the disease, it is difficult to confirm the diagnosis before surgery.
Secondary infection of fluid-containing bronchoalveolar cyst and pericardial cyst secondary infection is difficult to identify on the X-ray, but pericardial cysts have no respiratory symptoms, such as cough and sputum, etc., is the main identification point, the epidermoid cyst is generally good site High, basically limited to the anterior mediastinum, when the invasion of the lungs and the bronchus can cough up sebum-like substances or hair, diagnostic puncture can also wear a yellow, tan or white transparent sebum-like substance, except for cardiovascular imaging CT or ultrasound examination of cardiac swelling tumors or aneurysms may help to distinguish between pericardial fat pads, thymoma, and diaphragmatic tumors.
