Lung Abscess with a Refractory Bronchopleural Fistula Saved from Potentially Fatal Sepsis by Omentoplasty and Extracorporeal Membrane Oxygenation

Controlling air leaks during thoracic drainage in patients with lung abscesses caused by bronchopleural fistulas is challenging. To reduce the occurrence of air leaks, positive pressure ventilation should be avoided whenever possible. A 69-year-old man presented with a 10-day history of gradually wo...

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Main Authors: Jumpei Takamatsu, Jinkoo Kang, Aya Fukuhara, Yuichi Yasue, Sae Kawata
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2021/9025990
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author Jumpei Takamatsu
Jinkoo Kang
Aya Fukuhara
Yuichi Yasue
Sae Kawata
author_facet Jumpei Takamatsu
Jinkoo Kang
Aya Fukuhara
Yuichi Yasue
Sae Kawata
author_sort Jumpei Takamatsu
collection DOAJ
description Controlling air leaks during thoracic drainage in patients with lung abscesses caused by bronchopleural fistulas is challenging. To reduce the occurrence of air leaks, positive pressure ventilation should be avoided whenever possible. A 69-year-old man presented with a 10-day history of gradually worsening chest pain. He had lost consciousness and was brought to the emergency room. His SpO2 was approximately 70%, and his systolic blood pressure was approximately 60 mmHg. Chest radiography and computed tomography revealed findings suggestive of a right pyothorax. Therefore, thoracic drainage was performed. However, the patient’s respiratory status did not improve, and his circulatory status could not be maintained. Therefore, extracorporeal membrane oxygenation was introduced after the improvement in circulation by noradrenaline and fluid resuscitation, resulting in adequate oxygenation and ventilation without the use of high-pressure ventilator settings. Subsequently, omentoplasty for a refractory bronchopleural fistula was successfully performed, and the air leak was cured without recurrence of the lung abscess.
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spelling doaj-art-54f35b6debb547e4ba3ff32aac66991f2025-08-20T03:34:21ZengWileyCase Reports in Critical Care2090-64202090-64392021-01-01202110.1155/2021/90259909025990Lung Abscess with a Refractory Bronchopleural Fistula Saved from Potentially Fatal Sepsis by Omentoplasty and Extracorporeal Membrane OxygenationJumpei Takamatsu0Jinkoo Kang1Aya Fukuhara2Yuichi Yasue3Sae Kawata4Department of Emergency Medicine, Kansai Rosai Hospital, Amagasaki, JapanDepartment of Emergency Medicine, Kansai Rosai Hospital, Amagasaki, JapanDepartment of Emergency Medicine, Kansai Rosai Hospital, Amagasaki, JapanDepartment of Emergency Medicine, Kansai Rosai Hospital, Amagasaki, JapanDepartment of Emergency Medicine, Kansai Rosai Hospital, Amagasaki, JapanControlling air leaks during thoracic drainage in patients with lung abscesses caused by bronchopleural fistulas is challenging. To reduce the occurrence of air leaks, positive pressure ventilation should be avoided whenever possible. A 69-year-old man presented with a 10-day history of gradually worsening chest pain. He had lost consciousness and was brought to the emergency room. His SpO2 was approximately 70%, and his systolic blood pressure was approximately 60 mmHg. Chest radiography and computed tomography revealed findings suggestive of a right pyothorax. Therefore, thoracic drainage was performed. However, the patient’s respiratory status did not improve, and his circulatory status could not be maintained. Therefore, extracorporeal membrane oxygenation was introduced after the improvement in circulation by noradrenaline and fluid resuscitation, resulting in adequate oxygenation and ventilation without the use of high-pressure ventilator settings. Subsequently, omentoplasty for a refractory bronchopleural fistula was successfully performed, and the air leak was cured without recurrence of the lung abscess.http://dx.doi.org/10.1155/2021/9025990
spellingShingle Jumpei Takamatsu
Jinkoo Kang
Aya Fukuhara
Yuichi Yasue
Sae Kawata
Lung Abscess with a Refractory Bronchopleural Fistula Saved from Potentially Fatal Sepsis by Omentoplasty and Extracorporeal Membrane Oxygenation
Case Reports in Critical Care
title Lung Abscess with a Refractory Bronchopleural Fistula Saved from Potentially Fatal Sepsis by Omentoplasty and Extracorporeal Membrane Oxygenation
title_full Lung Abscess with a Refractory Bronchopleural Fistula Saved from Potentially Fatal Sepsis by Omentoplasty and Extracorporeal Membrane Oxygenation
title_fullStr Lung Abscess with a Refractory Bronchopleural Fistula Saved from Potentially Fatal Sepsis by Omentoplasty and Extracorporeal Membrane Oxygenation
title_full_unstemmed Lung Abscess with a Refractory Bronchopleural Fistula Saved from Potentially Fatal Sepsis by Omentoplasty and Extracorporeal Membrane Oxygenation
title_short Lung Abscess with a Refractory Bronchopleural Fistula Saved from Potentially Fatal Sepsis by Omentoplasty and Extracorporeal Membrane Oxygenation
title_sort lung abscess with a refractory bronchopleural fistula saved from potentially fatal sepsis by omentoplasty and extracorporeal membrane oxygenation
url http://dx.doi.org/10.1155/2021/9025990
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