Chai Chan Sin, Chan Swee Kim, Kho Sze Shyang, Yong Mei Ching, Tie Siew Teck
Division of Respiratory Medicine, Department of Internal Medicine Sarawak General Hospital Kuching Sarawak Malaysia.
Respirol Case Rep. 2020 Apr 18;8(5):e00562. doi: 10.1002/rcr2.562. eCollection 2020 Jul.
Bronchopleural fistula (BPF) can complicate necrotizing pneumonia. Surgery would be indicated in patients who fail conservative management, yet this group is often of poor pulmonary function and general condition. Bronchial occlusion with endobronchial Watanabe spigots (EWS) can be a potential alternative treatment when the culprit bronchi can be isolated. In this case report, we describe a middle-aged gentleman who presented with necrotizing pneumonia complicated with pyopneumothorax with right upper lobe BPF, and who had failed to respond to chest drainage and antibiotics. EWS bronchial occlusion finally led to cessation of air leak, allowing removal of chest tube. EWS were removed uneventfully six months later. This case highlights the role of EWS in the management of BPF in patients with high surgical risk.
支气管胸膜瘘（BPF）可使坏死性肺炎复杂化。对于保守治疗失败的患者可考虑手术治疗，但这类患者的肺功能和一般状况往往较差。当能够确定责任支气管时，使用支气管内渡边栓子（EWS）进行支气管封堵可能是一种潜在的替代治疗方法。在本病例报告中，我们描述了一位中年男性，他患有坏死性肺炎并伴有右肺上叶BPF合并脓气胸，对胸腔引流和抗生素治疗无反应。EWS支气管封堵最终导致漏气停止，从而可以拔除胸腔引流管。六个月后EWS顺利取出。本病例突出了EWS在手术风险高的BPF患者管理中的作用。
