title: Successful closure of a bronchopleural fistula by intrapleural administration of fibrin sealant: a case report with review of literature.
abstract: BACKGROUND
  There are no established guidelines for the proper treatment of patients with bronchopleural fistulas (BPFs). Apart from attempts to close the fistula, emphasis of treatment and management is placed on preventive measures, early administration of antibiotics, drainage of the empyema and aggressive nutritional and rehabilitative support.
  
  
  METHODS
  A 53-year-old male presented with nausea, vomiting, and dry cough with eventual respiratory failure. He was found to have an empyema of the left hemithorax which was managed with thoracostomy drainage and antibiotics. However, he had persistent air leak through the chest tube due to a BPF. Bronchoscopy failed to localize the involved segment. Application of fibrin glue through the chest tube succeeded in completely sealing the leak.
  
  
  CONCLUSIONS
  To our knowledge, this is the first case report in which fibrin glue was successfully used intrapleurally to close a BPF related to an empyema.
authors.affiliation: Department of Internal Medicine, Newark, New Jersey, USA ; Department of Pulmonary Medicine, Newark, New Jersey, USA.
authors.forename: Pranabh
authors.initials: P
authors.lastname: Shrestha
authors.affiliation: Department of Internal Medicine, Newark, New Jersey, USA ; Department of Pulmonary Medicine, Newark, New Jersey, USA.
authors.forename: Syed Aatif
authors.initials: SA
authors.lastname: Safdar
authors.affiliation: Department of Internal Medicine, Newark, New Jersey, USA ; Department of Pulmonary Medicine, Newark, New Jersey, USA.
authors.forename: Sami Abdul
authors.initials: SA
authors.lastname: Jawad
authors.affiliation: Department of Internal Medicine, Newark, New Jersey, USA ; Department of Hematology and Oncology, St. Michael's Medical Center, Newark, New Jersey, USA.
authors.forename: Hamid
authors.initials: H
authors.lastname: Shaaban
authors.affiliation: Department of Internal Medicine, Newark, New Jersey, USA ; Department of Pulmonary Medicine, Newark, New Jersey, USA.
authors.forename: Javier
authors.initials: J
authors.lastname: Dieguez
authors.affiliation: Department of Internal Medicine, Newark, New Jersey, USA ; Department of Pulmonary Medicine, Newark, New Jersey, USA.
authors.forename: Enas
authors.initials: E
authors.lastname: Elberaqdar
authors.affiliation: Department of Internal Medicine, Newark, New Jersey, USA.
authors.forename: Srijana
authors.initials: S
authors.lastname: Rai
authors.affiliation: Department of Internal Medicine, Newark, New Jersey, USA ; Department of Pulmonary Medicine, Newark, New Jersey, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Adelman
keywords: Bronchopleural fistula; Fibrin sealant; Intrapleural