Intractable pneumothorax with empyema in a patient with interstitial pneumonia

• Published in: General thoracic and cardiovascular surgery Vol. 61; no. 10; pp. 574 - 577
• Main Authors: Miyoshi, Shinichiro, Tamura, Motohiko, Araki, Osamu, Ikeda, Yasunori, Chida, Masayuki
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.10.2013; Springer Nature B.V
• Subjects: Aged; Antibiotics; Cardiac Surgery; Cardiology; Case Report; Chest tubes; Chronic obstructive pulmonary disease; Drainage; Empyema, Pleural - etiology; Empyema, Pleural - therapy; Female; Fistula; Fistula - surgery; Humans; Lung - surgery; Lung Diseases, Interstitial - complications; Medical imaging; Medicine; Medicine & Public Health; Microorganisms; Patients; Pneumonectomy; Pneumonia; Pneumothorax; Pneumothorax - etiology; Pneumothorax - surgery; Staphylococcus infections; Surgical Oncology; Thoracic Surgery; Thoracic Wall - surgery; Thoracostomy - methods; Empyema; Pneumothorax; Muscle flap transposition; Interstitial pneumonia
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-012-0162-8

Secondary pneumothorax occurring in interstitial lung disease cases is a refractory and life-threatening condition, because of compromised lung function. A 70-year-old woman with interstitial pneumonia was referred to our hospital after treatment failure for pneumothorax associated with empyema. An open window thoracostomy was created, and mechanical irrigation and dressing changes of the pleural cavity were performed. Then, the lung was widely covered with the latissimus dorsi and serratus anterior muscles because there were multiple fistulae on the lung surface. After the covering muscles were completely adhered to the lung surface and stopped air leaking, the chest was successfully closed. The wide covering technique of the lung with chest wall muscles is effective for intractable pneumothorax with multiple fistulae.