[MRSA pyothorax due to bronchopleural fistula after grafting and pneumonectomy for traumatic aneurysm of the thoracic aorta--a successful treatment by open drainage and omentopexy].
Treatment of postpneumonectomy pyothorax due to bronchopleural fistula (BPF) is troublesome, especially with methicillin-resistant staphylococcus aureus (MRSA) infection. Moreover, in a bypass-grafting case, the management becomes more complicated. We reported a successful treated case of MRSA pyothorax due to BPF after grafting and pneumonectomy. In a 48-year-old woman performed grafting and pneumonectomy for traumatic aneurysm of the thoracic aorta, MRSA pyothorax due to BPF occurred. BPF was successfully closed by fibrin-glueing under bronchofiberscopy. However pyothorax was not improved by thoracic irrigation for a month. Therefore, open pleural drainage underwent. At the same time, bronchial stump and graft surface was covered with the omental pedicle flap. The open wound had become sterile in two months, and the thoracic window was closed three months after the open drainage.
Yuasa
H
H
Department of Respiratory Surgery, University of Tsukuba Hospital, Ibaraki, Japan.
Onizuka
M
M
Ijima
H
H
Akaogi
E
E
Mitsui
K
K
Hori
M
M
D001013:Aorta, Thoracic / Q000601:surgery; D001014:Aortic Aneurysm / Q000209:etiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D001983:Bronchial Fistula / Q000150:complications / Q000601:surgery*; D004322:Drainage / Q000379:methods; D016724:Empyema, Pleural / Q000209:etiology / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000150:complications / Q000601:surgery*; D006801:Humans; D016106:Methicillin Resistance; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D010995:Pleural Diseases / Q000150:complications / Q000601:surgery*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000601:surgery*; D013203:Staphylococcal Infections / Q000209:etiology / Q000601:surgery*; D013211:Staphylococcus aureus / Q000187:drug effects*; D013524:Surgical Flaps; D013898:Thoracic Injuries / Q000150:complications*