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. 2024 Nov 6;12(11):e70053.
doi: 10.1002/rcr2.70053. eCollection 2024 Nov.

Successful treatment of a persistent air leak with an endobronchial valve in a 17-year-old patient with necrotizing pneumonia

Nina M Janssen  1 , Rein Posthuma  1 , Sophie Kienhorst  2 , Michiel A G E Bannier  2 , Ulrich C Lalji  3 , Frits M E Franssen  1 , Roy T M Sprooten  1
Affiliations

Successful treatment of a persistent air leak with an endobronchial valve in a 17-year-old patient with necrotizing pneumonia

Nina M Janssen et al. Respirol Case Rep. .

Abstract

Pleural empyema is a severe condition associated with high morbidity and mortality. Treatment usually consists of pleural drainage with chest tube or surgery, in combination with antimicrobial treatment. Severe pneumonia can evolve in a necrotizing pneumonia, given a higher susceptibility to the occurrence of bronchopleural fistulas with persistent air leaks. This complicates recovery, and surgery may not always be the optimal treatment. We present a case involving a 17-year-old female patient who experienced a post-operative persistent air leak due to necrotizing pneumonia after video-assisted thoracic surgery decortication for empyema, which was successfully treated using an endobronchial valve. After 6 months the valve was removed without complications. Follow-up imaging and lung function revealed a limited area of atelectasis and minimal pleural thickening with normal lung volumes.

Keywords: bronchopleural fistula; necrotizing pneumonia; persistent air leak; unidirectional endobronchial valve.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
(A) Chest computed tomography (CT) scan showing necrotizing pneumoniae of the right upper lobe with a chest tube in place, before placing the endobronchial valve. (B) Chest CT scan showing a reduction of cavetating lesion of a necrotizing pneumonia of the right upper lobe 1 month after placement of endobronchial valve with the endobronchial valve in place. (C) Chest CT scan 1 year after placement en 6 months after the subsequent removal of the endobronchial valve, showing a limited area of atelectasis and minimal pleural thickening.
FIGURE 2
FIGURE 2
Position of the unidirectional endobronchial valve in B2 segmental branch.
See this image and copyright information in PMC

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