A Case of Peripheral Bronchopleural Fistula Treated by Flexible Bronchoscopy with Gelfoam Occlusion.

Lee, Seung Heon; Hur, Gyu Young; Kim, Je Hyeong; Lee, Sang Yeub; Shin, Chol; Shim, Jae Jeong; In, Kwang Ho; Kang, Kyung Ho; Yoo, Se Hwa

doi:2002.53.2.221

Tuberc Respir Dis > Volume 53(2); 2002 > Article

Case Report

Tuberculosis and Respiratory Diseases 2002;53(2):221-226.
DOI: https://doi.org/10.4046/trd.2002.53.2.221 Published online August 1, 2002.

A Case of Peripheral Bronchopleural Fistula Treated by Flexible Bronchoscopy with Gelfoam Occlusion.

Seung Heon Lee, Gyu Young Hur, Je Hyeong Kim, Sang Yeub Lee, Chol Shin, Jae Jeong Shim, Kwang Ho In, Kyung Ho Kang, Se Hwa Yoo

Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea. jaejshim@kumc.or.kr

Abstract

A 58-year-old man was admitted after suffering dyspnea and pleuritic chest pain on his right side for one week. A chest X-ray revealed necrotizing pneumonia and a lung abscess on right upper lobe. Despite of antibiotics and supportive care, a complicated parapneumonic effusion developed on his right side. Closed thoracostomy was performed for drainage. However, after the thoracostomy, a bronchopleural fistula (BPF) occurred with a continuous air leak. After 30 days intensive therapy, the underlying necrotizing pneumonia and lung abscess resolved, but the BPF continued. Bronchoscopic treatment was performed because the patient was a poor candidate for surgery. After localizing the BPF with a systemic occlusion of the segmental bronchi, small strips of Gelfoam were placed in the suction channel of the flexible bronchoscopy, and either flushed with a saline solution or inserted with forceps until the cessation of air leak. The patient was discharged 10 days after the bronchoscopic treatment.

Key Words: Bronchopleural fistula, Bronchoscopy, Gelfoam