Abstract
症例は21歳女性.眼筋型重症筋無力症と診断され, 加療を受けていた.胸部CT上胸腺腫を疑われ, 胸骨縦切開下に拡大胸腺摘出術を行った.術直後の胸部X線写真で右上葉の無気肺を認めた.気管支鏡で観察すると右上葉気管支は気管分岐部直上の右側気管より分岐し, 同部に疾の貯留を認めた.気管支鏡で吸疾し, 無気肺は改善した.術後, 胸部CTを再検討すると, 右気管支分岐異常を確認することが出来た.患者はその後は良好に経過した.気管支分岐異常は比較的稀な疾患であるが, 今回は術中無気肺を生じており, 術中術後の呼吸管理に問題を生じる可能性がある.胸部手術の際, 念頭に置くべき疾患であると考えられた.
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