Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 9 , ISSUE 1 ( January-June, 2020 ) > List of Articles

CASE REPORT

Bronchopleural Fistula Closure with Vascular Plug and Intrapleural Glue Administration

Neeraj Sharma, Vasu Vardhan, Chandan Singh Katoch, Aseem Yadav

Keywords : Bronchopleural fistula, bronchoscopy, fibrin sealant, vascular plug

Citation Information : Sharma N, Vardhan V, Katoch CS, Yadav A. Bronchopleural Fistula Closure with Vascular Plug and Intrapleural Glue Administration. Indian J Respir Care 2020; 9 (1):106-109.

DOI: 10.4103/ijrc.ijrc_17_19

License: CC BY-NC-SA 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2020; Indian Journal of Respiratory Care.


Abstract

The presence of communication between a mainstem, lobar, or segmental bronchus and the pleural place is called a bronchopleural fistula (BPF). It is commonly caused as a result of postoperative complication of lung resection surgeries, chemotherapy or radiotherapy for lung cancer, persistent spontaneous pneumothorax, empyema, lung abscess, and tuberculosis. A 20-year-old male underwent decortication for diffuse right-sided tuberculous pleural thickening. Postsurgery, he developed BPF. He underwent open thoracic surgery for BPF closure. However, he continued to have air leak and persistent empyema. Repeat evaluation revealed a large BPF at the anterior segment of the right upper lobe on computed tomography chest, which was confirmed on bronchoscopy. He underwent bronchoscopic closure (under fluoroscopic guidance) of BPF with a 6 mm × 7 mm vascular plug successfully. Major air leak stopped and lung expansion increased on chest X-ray. However, small air leaks (alveolar-pleural fistula) persisted. Later, he was subjected to intrapleural diluted fibrin glue administration (fibrinogen + aprotinin + thrombin) via a chest tube at bedside. Application of diluted fibrin glue through the chest tube succeeded in completely sealing the small air leaks. Radiologically, there was no further lung collapse and the pleural space was nearly obliterated.


HTML PDF Share
  1. Cerfolio RJ. The incidence, etiology, and prevention of postresectional bronchopleural fistula. Semin Thorac Cardiovasc Surg 2001;13:3-7.
  2. Shrestha P, Safdar SA, Jawad SA, Shaaban H, Dieguez J, Elberaqdar E, et al. Successful closure of a bronchopleural fistula by intrapleural administration of fibrin sealant: A case report with review of literature. N Am J Med Sci 2014;6:487-90.
  3. Fruchter O, Kramer MR, Dagan T, Raviv Y, Abdel-Rahman N, Saute M, et al. Endobronchial closure of bronchopleural fistulae using amplatzer devices: Our experience and literature review. Chest 2011;139:682-7.
  4. Yasuda Y, Mori A, Kato H, Fujino S, Asakura S. Intrathoracic fibrin glue for postoperative pleuropulmonary fistula. Ann Thorac Surg 1991;51:242-4.
  5. Kinoshita T, Miyoshi S, Katoh M, Yoshimasu T, Juri M, Maebeya S, et al. Intrapleural administration of a large amount of diluted fibrin glue for intractable pneumothorax. Chest 2000;117:790-5.
  6. Baxter. Tisseel (Fibrin Sealant) Information. Available from: http://tisseel.com/us/pdf/2012-0125_PI_TISSEEL_.pdf. [Last accessed on 2013 Jan 20].
  7. Katoch CD, Chandran VM, Bhattacharyya D, Barthwal MS. Closure of bronchopleural fistula by interventional bronchoscopy using sealants and endobronchial devices. Med J Armed Forces India 2013;69:326-9.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.