Endobronchial Watanabe spigot embolisation in the treatment of bronchopleural fistula due to tuberculous empyema in intensive care unit.
Tuberculosis may be complicated with empyema and fistula in patients with cellular immune deficiency. The case presented was a 39-year-old male patient with diagnosis of rheumatoid arthritis developed hydropneumothorax while taking steroid and immunosuppressive treatment and examination of pleural fluid revealed acid-fast bacilli. The patient was admitted to the intensive care unit due to respiratory failure and underwent bronchoscopic examination due to air leakage. The right middle lobe was obliterated by using an endobronchial Watanabe Spigot (EWS), and the amount of leakage decreased considerably after the procedure. On day 7, chest tube drainage was removed, and empyema was drained with a Pezzer drain. On day 50, upon the cessation of empyema drainage, spigots were removed with rigid and flexible bronchoscope. In conclusion, EWS use in the treatment of bronchopleural fistula is an effective, safe and a reversible procedure.
Interventional Pulmonology Unit, Yedikule Chest Diseases and Thoracic Surgery Teaching Hospital, Istanbul, Turkey. leventdalar@gmail.com
Levent
L
Dalar
Filizs
F
Kosar
Emel
E
Eryuksel
Levent
L
Karasulu
Sedat
S
Altin
D000328:Adult; D001983:Bronchial Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy / Q000295:instrumentation*; D004322:Drainage; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004654:Empyema, Tuberculous / Q000150:complications*; D004867:Equipment Design; D006801:Humans; D006872:Hydropneumothorax / Q000209:etiology / Q000628:therapy; D007362:Intensive Care Units; D008297:Male; D010995:Pleural Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011859:Radiography; D016896:Treatment Outcome