 |
JOURNAL TOOLS |
| Publishing options |
| eTOC |
| To subscribe |
| Submit an article |
| Recommend to your librarian |
ARTICLE TOOLS |
| Publication history |
| Reprints |
| Permissions |
| Cite this article as |
| Share |
YOUR ACCOUNT
YOUR ORDERS
SHOPPING BASKET
Items: 0
Total amount: € 0,00
HOW TO ORDER
YOUR SUBSCRIPTIONS
YOUR ARTICLES
YOUR EBOOKS
COUPON
ACCESSIBILITY
CASE REPORT
Minerva Respiratory Medicine 2023 March;62(1):54-7
DOI: 10.23736/S2784-8477.22.02014-9
Copyright © 2022 EDIZIONI MINERVA MEDICA
language: English
Life-threatening pulmonary laceration following bronchoscopic lung volume reduction
Filippo PATRUCCO 1, 2, Sara PARINI 3, Matteo DAVERIO 1, Maddalena SARCOLI 1, Rossella MOLINARI 1, Gian C. VALLESE 1, Ottavio RENA 3, Piero E. BALBO 1 ✉
1 Division of Respiratory Diseases, Medical and Specialistic Department, AOU Maggiore della Carità di Novara, Novara, Italy; 2 Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; 3 Thoracic Surgery Unit, Cardiovascular and Thoracic Department, AOU Maggiore della Carità di Novara, Novara, Italy
We report on a case of a 69-year-old female patient affected by centrilobular and panlobular emphysema, who underwent bronchoscopic lung volume reduction. After evaluation of collateral ventilation, three endobronchial valves were placed in left upper lobe segmental bronchi. Two days after the procedure, the patient developed a pneumothorax, requiring chest tube placement with drainage of 1300 mL of hemorrhagic pleural fluid, and loss of 5 g/dL of hemoglobin. Computed tomography revealed hemothorax and intraparenchymal hematoma. The patient underwent urgent thoracoscopy that revealed multiple pleural adhesions and a large intraparenchymal hematoma involving the S6 segment, source of active bleeding. A S6 anatomical segmentectomy was performed to control the bleeding. The patient rapidly recovered. Iatrogenic pneumothorax after bronchoscopic lung volume reduction is a sign of complete atelectasis of the treated lobe; pleural adhesions are probably the responsible of the occurrence of pneumothorax, stressing visceral pleural and then causing air leak. The Pleural Adhesion Score, based on the number of adhesions visible at computed tomography, could predict the occurrence of post-procedural pneumothorax.
KEY WORDS: Pneumonectomy; Pulmonary emphysema; Bronchoscopy; Pneumothorax; Pleura