Ramadurai Deepa, DiBardino David M, Hong Gina
Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Section of Interventional Pulmonology and Thoracic Oncology, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Respir Med Case Rep. 2021 Nov 10;34:101554. doi: 10.1016/j.rmcr.2021.101554. eCollection 2021.
Secondary pneumothorax is a rare but serious complication of allergic bronchopulmonary aspergillosis (ABPA) and bronchiectasis [1,2]. Persistent air leak (PAL) after secondary pneumothorax is an ongoing abnormal communication between bronchi or alveoli and the pleural space, despite drainage. Ongoing PAL for 5 days after initial chest tube insertion necessitates prolonged ambulatory drainage or aggressive management with video-assisted thoracoscopic surgery (VATS) or pleurodesis [3,4]. There are no randomized trials examining the efficacy of endobronchial valves (EBVs) for PAL with underlying inflammatory pulmonary disease. We describe the successful use of an EBV for PAL in a man with ABPA on high dose steroids, with a large bronchopleural fistula (BPF).
继发性气胸是变应性支气管肺曲霉病（ABPA）和支气管扩张症罕见但严重的并发症[1,2]。继发性气胸后的持续性漏气（PAL）是指尽管进行了引流，但支气管或肺泡与胸膜腔之间仍存在持续的异常相通。初始插入胸管后持续5天的PAL需要延长门诊引流或采用电视辅助胸腔镜手术（VATS）或胸膜固定术进行积极处理[3,4]。尚无随机试验研究支气管内瓣膜（EBV）对伴有潜在炎性肺病的PAL的疗效。我们描述了一名接受高剂量类固醇治疗、患有大支气管胸膜瘘（BPF）的ABPA男性患者成功使用EBV治疗PAL的情况。
