The benefit of indwelling pleural catheter with ambulatory pneumothorax device and autologous blood patch pleurodesis in lymphangioleiomyomatosis with persistent air leak

• Published in: Respirology case reports Vol. 11; no. 5; pp. e01143 - n/a
• Main Authors: Ng, Boon Hau, Low, Hsueh Jing, Nik Abeed, Nik Nuratiqah, Jailaini, Mas Fazlin Mohamad, Abdul Hamid, Mohamed Faisal, Ban Yu‐Lin, Andrea
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.05.2023; John Wiley & Sons, Inc; Wiley
• Subjects: Biopsy; blood patch pleurodesis; Case Report; Case Reports; Chest tubes; Conflicts of interest; Cysts; indwelling pleural catheter; Literature reviews; Lung diseases; lymphangioleiomyomatosis; Ostomy; Patients; persistent air leak; Pneumothorax; Thoracic surgery; Thorax; Tomography; persistent air leak; lymphangioleiomyomatosis; blood patch pleurodesis; indwelling pleural catheter; pneumothorax
• ISSN: 2051-3380; 2051-3380
• DOI: 10.1002/rcr2.1143

We report a 35‐year‐old woman who presented with dyspnoea and chest pain for 1 week. High‐resolution computed tomography (HRCT) thorax revealed bilateral pneumothoraces with diffuse lung cysts. Bilateral intercostal chest tubes were inserted, and there was a persistent air leak (PAL) bilaterally. We performed an autologous blood patch pleurodesis (ABPP) for the left PAL. For the right PAL, she underwent a successful right video‐assisted thoracic (VATS) surgery, wedge biopsy, and surgical pleurodesis. Histopathology examination confirmed the diagnosis of lymphangioleiomyomatosis (LAM). The left pneumothorax recurred. An indwelling pleural catheter (Rocket® IPC™; Rocket Medical plc; WASHINGTON) was inserted and the patient was discharged after 1 day with an atrium pneumostat (Pneumostat™; Atrium Medical Corporation, Hudson, NH, USA) chest drain valve. The patient was initiated on Sirolimus 2 mg daily. The left PAL resolved at 6 weeks. This case highlights the benefit of IPC with an ambulatory pneumothorax device in a patient with LAM with PAL. Lymphangioleiomyomatosis (LAM) is a rare cystic lung disease with the progressive formation of numerous small cysts. The course of the disease is complicated by recurrent pneumothoraces. This occurs due to cyst rupture into the pleural space or through alveolar wall disruption resulting in an air leak. Chemical or surgical pleurodesis is performed to prevent a recurrence. Persistent air leak (PAL) can complicate this condition. We report the successful use of IPC with an ambulatory pneumothorax device in a patient with LAM with PAL.