Combined intrapleural and intrabronchial injection of fibrin glue for closing alveolar pleural fistula: a case report

Abstract Background The treatment of persistent air leak is a challenge. Herein, we reported the combined intrabronchial and intrapleural injection of fibrin glue using fiber bronchoscopy to seal off an alveolar pleura fistula developed following necrotizing pneumonia in high-risk patient. Case presentation A 74-year-old man was intubated in emergency for acute ischemic stroke. Percutaneous dilatational tracheostomy was then performed, and 15 days later patient returned to spontaneous breathing. However, he developed alveolar pleural fistula following necrotizing pneumonia with persistent air leaks. The intrabronchial and intrapleural injection of fibrin glue using fiber bronchoscopy sealed off the alveolar pleura fistula after that other endoscopic treatments as bronchial valve and intrabronchial fibrin glue application had failed. Conclusions Our strategy is safe and easy to reproduce. It represents an additional method in the armamentarium of the physicians for the management of PAL when all standard strategies are unfeasible or fail.

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Persistent Air Leak Complicating Staphylococcus Aureus Necrotizing Pneumonia

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a6898 ◽

2020 ◽

Author(s):

I.C. Wawrzeniak ◽

F.C. Conci ◽

J.A.M. Peruchi ◽

E.E. Turra ◽

K.B.D.A. Moura ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Necrotizing Pneumonia ◽

Air Leak ◽

Persistent Air Leak

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A rare case of persistent air leak: beware of all the tubes

International Journal of Emergency Medicine ◽

10.1186/s12245-021-00381-6 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Amarja Ashok Havaldar ◽

Abdul Rahim Fazal ◽

Abhilash Chennabasappa

Keyword(s):

Mechanical Ventilation ◽

Care Center ◽

Invasive Mechanical Ventilation ◽

Respiratory Muscles ◽

Air Leak ◽

Ventilator Support ◽

Case Presentation ◽

Health Care Center ◽

Ventilation Monitoring ◽

Persistent Air Leak

Abstract Background Patients with acute respiratory failure, impaired consciousness, and impaired airway reflexes will require invasive mechanical ventilation. Monitoring of such patients is important. The use of ventilator scalars and loops help in monitoring, diagnosing the abnormality, and treating the patients effectively. We report a rare cause one should suspect in a case of persistent and fixed air leak in a patient requiring mechanical ventilation. Case presentation We describe a 28-year-old young patient requiring ventilator support due to neuromuscular weakness. His neuromuscular weakness was rapidly progressing involving the respiratory muscles. The patient was intubated and put on mechanical ventilator support. He was transferred from another health care center to our hospital. On evaluation, the patient was intubated with ETT no 8. The patient had persistent air leak as observed on the ventilator graphics. We checked for ETT cuff malfunction, ventilator circuit, catheter mount, and HME for any disconnection causing the leak. The air leak which we observed in our patient was due to the malpositioned Ryle’s tube. Conclusions Vigilant monitoring of patients requiring mechanical ventilation is necessary. For the evaluation of the cause of air leak, algorithmic approach will help in correctly identifying the abnormality.

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Catamenial pneumothorax with partial liver herniation due to diaphragmatic laceration: a case report and literature review

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01407-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Satoshi Arakawa ◽

Hideki Matsudaira ◽

Yuki Noda ◽

Makoto Yamashita ◽

Jun Hirano ◽

...

Keyword(s):

Case Report ◽

Thoracoscopic Surgery ◽

Endometrial Tissue ◽

Diaphragmatic Defect ◽

Air Leak ◽

Case Presentation ◽

Catamenial Pneumothorax ◽

Liver Herniation ◽

The Right ◽

Persistent Air Leak

Abstract Background Catamenial pneumothorax is generally uncommon, with an incidence of less than 3–6% in women with spontaneous pneumothorax. As few cases of catamenial pneumothorax with diaphragmatic defect and liver herniation have been reported, this case report may be useful for understanding the cause and treatment. This case highlights the importance of the approach for liver hernia in patients with catamenial pneumothorax and endometriosis. Case presentation We report a case of catamenial pneumothorax in a 43-year-old woman with diaphragmatic partial liver hernia who was treated with thoracoscopic surgery. She was diagnosed with a right pneumothorax at menstruation onset. Chest computed tomography showed a nodule protruding above the right diaphragm. We performed thoracoscopic surgery to treat the persistent air leak and biopsied the nodule on the right diaphragm. There were blueberry spots on the diaphragm; the nodule was found to be the herniated liver. The diaphragmatic defect was sutured. Histological examination of the tissue near the partial prolapsed liver revealed endometrial tissue. Conclusions It is speculated that ectopic endometrial tissue in the diaphragm will periodically necrose to become a diaphragmatic tear, which is a pathway for air to enter the thoracic cavity and eventually a herniated liver. Thoracoscopic surgery should be considered in patients with catamenial pneumothorax when a diaphragmatic lesion is suspected.

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Role of the IBV Valve in Persistent Air Leak

Current Respiratory Medicine Reviews ◽

10.2174/1573398x10666140115232721 ◽

2014 ◽

Vol 9 (4) ◽

pp. 254-256

Author(s):

Salim Surani ◽

Shweta Rao ◽

Saherish Surani ◽

Joseph Varon

Keyword(s):

Air Leak ◽

Persistent Air Leak

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A case series of ischemic stroke with coronavirus disease 2019 in two Egyptian centers

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00259-z ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Nevine El Nahas ◽

Tamer Roushdy ◽

Eman Hamid ◽

Sherien Farag ◽

Hossam Shokri ◽

...

Keyword(s):

Ischemic Stroke ◽

Severe Acute Respiratory Syndrome ◽

Cerebrovascular Disorders ◽

Case Series ◽

Neurological Manifestations ◽

Case Presentation ◽

Novel Virus

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus that has been reported to have various neurological manifestations. Cerebrovascular disorders have been encountered as a coronavirus disease 2019 (COVID-19) presentation in our center during the pandemic. Case presentation We are presenting 10 cases with cerebrovascular manifestations after having COVID-19 few days prior to stroke. Conclusion Cerebrovascular manifestations can occur in association with COVID-19 and may have significant implications on prognosis and management.

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New pneumothorax complicating successful treatment of persistent air leak by endobronchial valves

Respirology Case Reports ◽

10.1002/rcr2.732 ◽

2021 ◽

Vol 9 (4) ◽

Author(s):

Yiu Cheong Yeung ◽

Yu Hong Chan ◽

Man Ying Ho ◽

Ming Chiu Chan ◽

Hau Chung Kwok ◽

...

Keyword(s):

Successful Treatment ◽

Air Leak ◽

Persistent Air Leak

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Chemical pleurodesis in the presence of persistent air leak

The Annals of Thoracic Surgery ◽

10.1016/0003-4975(89)90150-1 ◽

1989 ◽

Vol 47 (5) ◽

pp. 786-787 ◽

Cited By ~ 24

Author(s):

G.Hossein Almassi ◽

George B. Haasler

Keyword(s):

Air Leak ◽

Chemical Pleurodesis ◽

Persistent Air Leak

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Treatment of persistent air leak with endobronchial valves

Advances in respiratory medicine ◽

10.5603/arm.a2020.0075 ◽

2020 ◽

Vol 88 (1) ◽

pp. 27-29

Author(s):

Fransien Van Hende ◽

Kris Carron

Keyword(s):

Air Leak ◽

Persistent Air Leak

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Risk Factors and Epidemiology of Coccidioidomycosis Demonstrated by a Case of Spontaneous Pulmonary Rupture of Cavitary Coccidioidomycosis

Case Reports in Infectious Diseases ◽

10.1155/2016/8165414 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Amy A. Yau

Keyword(s):

Surgical Repair ◽

Oral Surgery ◽

Community Acquired Pneumonia ◽

Spontaneous Resolution ◽

Construction Work ◽

Air Leak ◽

Chest Computed Tomography ◽

Cavitary Lesion ◽

Hispanic Male ◽

Persistent Air Leak

A 31-year-old Hispanic male with no medical history was admitted for fevers, pleurisy, and cough after recent oral surgery and completing demolition and construction work in Juarez, Mexico. Imaging showed a 4.4 cm cavitary lesion and bilateral tree-in-bud opacities. Initial suspicion of bacterial infection confirmed with clinical improvement on culture specific antibiotics, but after discharge he returned with progression of symptoms and new dyspnea. Radiograph showed a pyopneumothorax. Chest computed tomography after thoracostomy showed worsening infiltrates and another cavitary lesion. Symptoms persisted despite addition of broad spectrum antibiotics. Surgical repair for persistent air leak was required. Weeks after discharge, cultures and serologies returned positive forCoccidioidomycosis immitis.Coccidioidesspecies cause up to 30% of community-acquired pneumonia and incidental cavitary lesions in endemic regions. Symptoms are nonspecific yet usually involve fatigue, cough, and pleurisy. Most hosts have spontaneous resolution; however, certain demographics such as Hispanics and diabetics, later diagnosed in our patient, have higher morbidity. As seen with our patient, cavitary rupture and bronchopleural fistulas are rare occurring in 2.6% of cavitary lesions. High suspicion based on symptoms and host demographics is important to assist in early diagnosis and treatment to avoid and treat this common pathogen’s presentations.

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