Persistent Pneumothorax: Alveolar pleural fistula due to a hole in a bulla
Journal Title: Sultan Qaboos University Medical Journal - Year 2019, Vol 19, Issue 2
Abstract
A22-year-old male patient, previously treated for pulmonary tuberculosis, presented to Sultan Qaboos University Hospital, Muscat, Oman in 2017 with sudden onset shortness of breath. Chest X-ray showed a pneumothorax on the left side [Figure 1A]. A 20F chest tube was placed and connected to a closed pleural drainage chamber with low suction. Te lung failed to expand fully even after ten days. A computed tomography scan showed a large multiloculated pneumothorax with large bulla in the left apical region. Toracoscopy revealed multiple emphysematous bullae in the left lung. Air was found to be leaking from a clean hole on one side of a large bulla in the left apex [Figure 1B]. Tis alveolar-pleural fstulalike behaviour probably accounted for the continuing air leak and the persistence of the pneumothorax. Te left lung apex including the bullae was resected using an endo-GIA™ stapler (Medtronic plc, Minneapolis, Minnesota, USA). Te staple line was covered with dissected parietal pleura. Mechanical pleurodesis was performed on the rest of the pleura. Te lung subsequently inflated fully and remained expanded on follow-up one month later.
Authors and Affiliations
Adil H. Al Kindi, Jayakrishnan B. , Saif M. Al Mubaihsi, Nasser A. Al Kemyani
Keywords
Related Articles
- EP ID EP49978
- DOI http://dx.doi.org/10.18295/squmj.2019.19.02.015
- Views 326
- Downloads 0
For Whom the Bell Does Not Toll: The invisible saga of cancer caregivers
Cancer care can be seen as a three- legged stool. Whereas, the centre of attention is the patient, care cannot be provided without healthcare providers and caregivers. Quality caregiving enhances the patient’s physical...
Heavy Metals in Seafood and Farm Produce from Uyo, Nigeria Levels and health implications
Objectives: Tis study aimed to obtain representative data on the levels of heavy metals in seafood and farm produce consumed by the general population in Uyo, Akwa Ibom State, Nigeria, a region known for the exploratio...
Acquired Crossed Aphasia in a Dextral
Phototoxic Rash during Therapy with Pramipexole in a Patient with Restless Legs Syndrome
First International Nursing Conference Oman Innovations in Nursing Education and Practice Leading to Quality Care Sultan Qaboos University, Oman, 28–29th November 2011