An Intricate Case of Pyopneumothorax with Trapped Right Lung Requiring Swift Adaptation and Multidisciplinary Collaboration

• Published in: Journal of clinical and diagnostic research Vol. 18; no. 8; pp. 01 - 03
• Main Authors: Sharma, Vipul, Bhatia, Jayant, Raj, Preeti
• Format: Journal Article
• Language: English
• Published: JCDR Research and Publications Private Limited 01.08.2024
• Subjects: decortication; double lumen tube; pneumonectomy; pneumothorax; pulmonary tuberculosis
• ISSN: 2249-782X; 0973-709X
• DOI: 10.7860/JCDR/2024/70621.19694

Pulmonary Tuberculosis (PTB) is a significant cause of morbidity, especially in patients with underlying health conditions. The present case highlights the complex management in a patient with intricate medical history, marked by tuberculosis, multiple Intercostal Chest Drain (ICD) procedures, and pyopneumothorax with long-standing diabetes mellitus and a history of smoking, adding to the uniqueness of the case. The authors present a case of a 67-year-old male, admitted for a right Pneumonectomy (PE) due to a complex combination of pyopneumothorax, right trapped lung and post-decortication status. However, due to the fragile nature of the tissue and the existence of vascular adhesions, it was decided to choose “physiological lung exclusion” by separating the affected lung from the tracheobronchial tree by cutting the bronchus and tying off the pulmonary artery, without removing any lung tissue, while keeping the pulmonary veins intact. The present report highlights the challenges faced, the multidisciplinary approach employed, and the successful surgical outcome, underscoring the importance of collaborative management.