title: Intractable pneumothorax managed by talc pleurodesis and bronchial occlusion with spigots.
abstract: Three cases of inoperable secondary spontaneous pneumothorax were diagnosed in patients with chronic obstructive pulmonary disease. Two cases initially underwent bronchial occlusion with endobronchial Watanabe spigot (EWS), while one underwent talc poudrage with pleuroscopy. As air leaks were not stopped completely in all cases with the initial procedures, we performed additional interventional treatments: pleuroscopic talc poudrage in cases when bronchial occlusion was performed first; and bronchial occlusion with EWS for a case that initially underwent talc pleurodesis. The air leaks ceased in all cases without complication. We successfully removed chest tubes 2-10 days after secondary procedure, which was 10-23 days after the first procedure. The combination of talc pleurodesis and bronchial occlusion with EWS, when a single, initial interventional treatment fails, can be considered in cases of intractable, inoperable secondary pneumothorax.
authors: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine Kawasaki, Japan.
authors: Atsuko
authors: A
authors: Ishida
authors: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine Kawasaki, Japan.
authors: Hirotaka
authors: H
authors: Kida
authors: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine Kawasaki, Japan.
authors: Hiromi
authors: H
authors: Muraoka
authors: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine Kawasaki, Japan.
authors: Hiroki
authors: H
authors: Nishine
authors: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine Kawasaki, Japan.
authors: Masamichi
authors: M
authors: Mineshita
authors: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine Kawasaki, Japan.
authors: Teruomi
authors: T
authors: Miyazawa
keywords: Chronic obstructive pulmonary disease; endobronchial Watanabe spigot; pleuroscopy; secondary spontaneous pneumothorax; talc poudrage