Delayed bronchial perforation after bulla cauterization with soft coagulation system
Abstract Background Soft coagulation is widely used for hemostasis because of its significant advantage in inducing tissue coagulation and denaturation without carbonization. However, a few cases of airway damage have been reported at the site, where soft coagulation was directly applied. Case prese...
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| Format: | Article |
| Language: | English |
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Japan Surgical Society
2021-11-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-021-01327-z |
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| author | Sakiko Kumata Katsunari Matsuoka Shinjiro Nagai Mitsuhiro Ueda Yoshinori Okada Yoshihiro Miyamoto |
| author_facet | Sakiko Kumata Katsunari Matsuoka Shinjiro Nagai Mitsuhiro Ueda Yoshinori Okada Yoshihiro Miyamoto |
| author_sort | Sakiko Kumata |
| collection | DOAJ |
| description | Abstract Background Soft coagulation is widely used for hemostasis because of its significant advantage in inducing tissue coagulation and denaturation without carbonization. However, a few cases of airway damage have been reported at the site, where soft coagulation was directly applied. Case presentation We encountered an unusual case of delayed perforation of the intermediate bronchial trunk observed on 24 days after cauterization of the right S6 bulla adjacent to the bronchus. Chest computed tomography revealed a large fistula between the intermediate bronchial trunk and the cauterized bulla in the right S6. Bronchoscopy showed a large fistula at the membranous portion of the intermediate bronchial trunk. We presumed that the bronchial perforation resulted from thermal damage to the intermediate bronchial trunk during bulla cauterization and the bronchial perforation induced infection in the bulla. Resection of the infectious bulla and the intermediate bronchial trunk, followed by end-to-end bronchial anastomosis and a pedicled intercostal muscle flap coverage, was performed. Conclusions The severe airway damage resulting in perforation developed even without direct contact between the electrode tip and the bronchial wall, provoking the need for special attention to the duration of cauterization and location, where it is used. |
| format | Article |
| id | doaj-art-630bb42eabd443b482ada5d23a2afe61 |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2021-11-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-630bb42eabd443b482ada5d23a2afe612025-08-20T03:33:38ZengJapan Surgical SocietySurgical Case Reports2198-77932021-11-01711410.1186/s40792-021-01327-zDelayed bronchial perforation after bulla cauterization with soft coagulation systemSakiko Kumata0Katsunari Matsuoka1Shinjiro Nagai2Mitsuhiro Ueda3Yoshinori Okada4Yoshihiro Miyamoto5Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku UniversityDepartment of Thoracic Surgery, National Hospital Organization Himeji Medical CenterDepartment of Thoracic Surgery, National Hospital Organization Himeji Medical CenterDepartment of Thoracic Surgery, National Hospital Organization Himeji Medical CenterDepartment of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku UniversityDepartment of Thoracic Surgery, National Hospital Organization Himeji Medical CenterAbstract Background Soft coagulation is widely used for hemostasis because of its significant advantage in inducing tissue coagulation and denaturation without carbonization. However, a few cases of airway damage have been reported at the site, where soft coagulation was directly applied. Case presentation We encountered an unusual case of delayed perforation of the intermediate bronchial trunk observed on 24 days after cauterization of the right S6 bulla adjacent to the bronchus. Chest computed tomography revealed a large fistula between the intermediate bronchial trunk and the cauterized bulla in the right S6. Bronchoscopy showed a large fistula at the membranous portion of the intermediate bronchial trunk. We presumed that the bronchial perforation resulted from thermal damage to the intermediate bronchial trunk during bulla cauterization and the bronchial perforation induced infection in the bulla. Resection of the infectious bulla and the intermediate bronchial trunk, followed by end-to-end bronchial anastomosis and a pedicled intercostal muscle flap coverage, was performed. Conclusions The severe airway damage resulting in perforation developed even without direct contact between the electrode tip and the bronchial wall, provoking the need for special attention to the duration of cauterization and location, where it is used.https://doi.org/10.1186/s40792-021-01327-zSoft coagulation systemThermal injuryBronchial perforationBronchopleural fistula |
| spellingShingle | Sakiko Kumata Katsunari Matsuoka Shinjiro Nagai Mitsuhiro Ueda Yoshinori Okada Yoshihiro Miyamoto Delayed bronchial perforation after bulla cauterization with soft coagulation system Surgical Case Reports Soft coagulation system Thermal injury Bronchial perforation Bronchopleural fistula |
| title | Delayed bronchial perforation after bulla cauterization with soft coagulation system |
| title_full | Delayed bronchial perforation after bulla cauterization with soft coagulation system |
| title_fullStr | Delayed bronchial perforation after bulla cauterization with soft coagulation system |
| title_full_unstemmed | Delayed bronchial perforation after bulla cauterization with soft coagulation system |
| title_short | Delayed bronchial perforation after bulla cauterization with soft coagulation system |
| title_sort | delayed bronchial perforation after bulla cauterization with soft coagulation system |
| topic | Soft coagulation system Thermal injury Bronchial perforation Bronchopleural fistula |
| url | https://doi.org/10.1186/s40792-021-01327-z |
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