Transthoracic Drainage of an Intrapulmonary Bronchogenic Cyst With an Intercostal Catheter.

Bronchogenic cysts are rare congenital anomalies stemming from the tracheobronchial tree. Often, they are incidental findings, but they can also cause significant symptom burdens such as coughing, haemoptysis, and respiratory distress. Generally, the optimal treatment is surgical excision via lobectomy, but not all patients are suitable for this. Herein, we present the case of an 84-year-old female with a large intrapulmonary bronchogenic cyst who presented with progressive dyspnoea, haemoptysis, and fevers. Due to relative contraindications for surgery, an ultrasound-guided percutaneous intercostal catheter insertion with administration of fibrinolytic and mucolytic therapy was performed to evacuate the contents. This approach demonstrated clinical and radiographic improvement to her symptoms without any significant complications. Similar approaches have previously been reported, but they were mainly in mediastinal and seldom in intrapulmonary bronchogenic cysts. Overall, a viable and effective minimally invasive alternative to surgery has been demonstrated in a high surgical risk patient.