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Case Reports
. 2023 Apr 12;11(5):e01143.
doi: 10.1002/rcr2.1143. eCollection 2023 May.

The benefit of indwelling pleural catheter with ambulatory pneumothorax device and autologous blood patch pleurodesis in lymphangioleiomyomatosis with persistent air leak

Boon Hau Ng  1 , Hsueh Jing Low  2 , Nik Nuratiqah Nik Abeed  1 , Mas Fazlin Mohamad Jailaini  1 , Mohamed Faisal Abdul Hamid  1 , Andrea Ban Yu-Lin  1
Affiliations
Case Reports

The benefit of indwelling pleural catheter with ambulatory pneumothorax device and autologous blood patch pleurodesis in lymphangioleiomyomatosis with persistent air leak

Boon Hau Ng et al. Respirol Case Rep. .

Abstract

We report a 35-year-old woman who presented with dyspnoea and chest pain for 1 week. High-resolution computed tomography (HRCT) thorax revealed bilateral pneumothoraces with diffuse lung cysts. Bilateral intercostal chest tubes were inserted, and there was a persistent air leak (PAL) bilaterally. We performed an autologous blood patch pleurodesis (ABPP) for the left PAL. For the right PAL, she underwent a successful right video-assisted thoracic (VATS) surgery, wedge biopsy, and surgical pleurodesis. Histopathology examination confirmed the diagnosis of lymphangioleiomyomatosis (LAM). The left pneumothorax recurred. An indwelling pleural catheter (Rocket® IPC™; Rocket Medical plc; WASHINGTON) was inserted and the patient was discharged after 1 day with an atrium pneumostat (Pneumostat™; Atrium Medical Corporation, Hudson, NH, USA) chest drain valve. The patient was initiated on Sirolimus 2 mg daily. The left PAL resolved at 6 weeks. This case highlights the benefit of IPC with an ambulatory pneumothorax device in a patient with LAM with PAL.

Keywords: blood patch pleurodesis; indwelling pleural catheter; lymphangioleiomyomatosis; persistent air leak; pneumothorax.

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Conflict of interest statement

Andrea Ban Yu‐Lin is an Editorial Board member of Respirology Case Reports and a co‐author of this article. They were excluded from all editorial decision‐making related to the acceptance of this article for publication. Andrea Ban Yu‐Lin is an Associate Editor for the Journal. The other authors have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
(A) Chest X‐ray showing bilateral pneumothorax with both chest tubes in situ. (B) Computed tomography of the thorax showing pneumothorax and scattered thin‐walled rounded cysts with normal intervening lung parenchyma. (C) Chest radiograph post‐IPC insertion. (D) Chest radiograph 6 weeks after IPC insertion showing resolved PAL and spontaneous autopleurodesis
See this image and copyright information in PMC

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