Bronchosubcutaneous fistula manifesting as massive subcutaneous emphysema treated successfully by endobronchial Watanabe spigots.
Masahiro YanagiyaNoriko HiyamaHideyuki TakeshimaKazuhiro UsuiJun MatsumotoPublished in: Respirology case reports (2020)
A bronchosubcutaneous fistula (BF) is an abnormal communication between the bronchus, pleural cavity, and subcutaneous tissue. Treatment of BF has been documented rarely. We describe a successful endoscopic bronchial occlusion using endobronchial Watanabe spigots (EWSs) for BF manifesting as massive subcutaneous emphysema (SE). A 78-year-old woman developed delayed localized SE following a surgical pleural biopsy for the diagnosis of primary lung cancer. Computed tomography (CT) of the chest revealed BFs resulting from pleural biopsy. The affected bronchi were identified using chest CT. We inserted EWSs into the affected bronchi with the aid of virtual bronchoscopic navigation. This bronchoscopic procedure achieved complete resolution of the SE by sealing the BFs without the need for surgical interventions.
Keyphrases
- ultrasound guided
- computed tomography
- fine needle aspiration
- dual energy
- image quality
- contrast enhanced
- positron emission tomography
- chronic obstructive pulmonary disease
- lung function
- magnetic resonance imaging
- idiopathic pulmonary fibrosis
- pulmonary fibrosis
- minimally invasive
- single molecule
- air pollution
- combination therapy
- newly diagnosed
- smoking cessation