Emergent bronchofiberoptic bronchial occlusion for intractable pneumothorax with severe emphysema

Emergent bronchofiberoptic bronchial occlusion using fibrin glue and woven polyglycolic acid mesh for persistent pneumothorax with severe emphysema is described. A 74-year-old man who had severe pulmonary dysfunction accompanying chronic emphysema was admitted with a complaint of sudden severe dyspn...

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Published inGeneral thoracic and cardiovascular surgery Vol. 46; no. 11; pp. 1078 - 1081
Main Authors Okada, S, Kano, K, Yamauchi, H, Satoh, S
Format Journal Article
LanguageEnglish
Published Japan Springer Nature B.V 01.11.1998
Subjects
Aged
Bronchoscopy
Catheters
Emergencies
Emphysema
Endoscopy - methods
Fiber Optic Technology
Fibrin Tissue Adhesive - therapeutic use
Humans
Male
Minimally Invasive Surgical Procedures - methods
Pneumothorax
Pneumothorax - etiology
Pneumothorax - surgery
Polyglycolic Acid
Polylactic acid
Pulmonary Emphysema - complications
Tissue Adhesives - therapeutic use
Treatment Outcome
Ventilators
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Summary:Emergent bronchofiberoptic bronchial occlusion using fibrin glue and woven polyglycolic acid mesh for persistent pneumothorax with severe emphysema is described. A 74-year-old man who had severe pulmonary dysfunction accompanying chronic emphysema was admitted with a complaint of sudden severe dyspnea. The chest X-ray on admission revealed collapse of the right lung. The patient was placed on a mechanical ventilator because of acute respiratory failure. In spite of continuous suction through a chest drainage tube, air leakage persisted. On the seventh hospital day, subcutaneous emphysema was apparent in the face and scrotum in addition to the chest. First, a double-lumen catheter was inserted into the right B5 bronchus, and fibrin glue was infused into the drainage bronchus via the double-lumen catheter. However, the procedure failed. Next, a combination of fibrin glue and woven polyglycolic acid mesh which had been cut into small pieces was introduced and pushed into the B5 bronchus using forceps. The air leakage stopped immediately after the administration. This procedure is simple and a minimally invasive method for the treatment of intractable pneumothorax in a compromised patient on a mechanical ventilator.
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ISSN:1344-4964
1863-6705
1863-2092
1863-6713
DOI:10.1007/BF03217879