Persistent Pneumothorax: Alveolar pleural fistula due to a hole in a bulla
Journal Title: Sultan Qaboos University Medical Journal - Year 2019, Vol 19, Issue 2
Abstract
A22-year-old male patient, previously treated for pulmonary tuberculosis, presented to Sultan Qaboos University Hospital, Muscat, Oman in 2017 with sudden onset shortness of breath. Chest X-ray showed a pneumothorax on the left side [Figure 1A]. A 20F chest tube was placed and connected to a closed pleural drainage chamber with low suction. Te lung failed to expand fully even after ten days. A computed tomography scan showed a large multiloculated pneumothorax with large bulla in the left apical region. Toracoscopy revealed multiple emphysematous bullae in the left lung. Air was found to be leaking from a clean hole on one side of a large bulla in the left apex [Figure 1B]. Tis alveolar-pleural fstulalike behaviour probably accounted for the continuing air leak and the persistence of the pneumothorax. Te left lung apex including the bullae was resected using an endo-GIA™ stapler (Medtronic plc, Minneapolis, Minnesota, USA). Te staple line was covered with dissected parietal pleura. Mechanical pleurodesis was performed on the rest of the pleura. Te lung subsequently inflated fully and remained expanded on follow-up one month later.
Authors and Affiliations
Adil H. Al Kindi, Jayakrishnan B. , Saif M. Al Mubaihsi, Nasser A. Al Kemyani
Keywords
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- EP ID EP49978
- DOI http://dx.doi.org/10.18295/squmj.2019.19.02.015
- Views 295
- Downloads 0
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