Abstract
We report herein the case of a woman with bronchopleural fistulas treated with the endobronchial placement of vascular embolization coils. She was referred to our hospital to undergo lavage of a postoperative empyema. She had undergone an air plombage operation for pulmonary tuberculosis 9 years previously. However, bronchopleural fistulas occurred postoperatively and she had to continue the use of a chest drainage tube since then. Lavage of her empyema space with 5kE of OK-432 (Picibanil: Chugai) plus 100 mg minocycline was performed once every 2 weeks for 3 months, and the purulent discharge from the empyema remarkably decreased. Thereafter, the bronchopleural fistulas were occluded endobronchially by the placement of vascular embolization coils. Soon after the procedure, air leakage from the fistulas was stopped and the drainage tube was removed 2 days later. The patient remains well without any additional treatment at 20 months after this treatment. As treatment for empyema with bronchopleural fistulas, it would be worth tryping to lavage the empyema space with OK-432 until it is cleaned out and to plug the fistulas by the endobronchial placement of embolization coils, before such radical operations as thoracoplasty and space-filling of the empyema are considered.
Similar content being viewed by others
References
Graham EA (1924) Principles involved in the treatment of acute and chronic empyema. Surg Gynecol Obstet 38:466–470
Dotter CT, Judkins MP (1964) Transluminal treatment of arteriosclerotic obstruction: description of a new technique and a preliminary report of its application. Circulation 30:654–670
Lunderquist A, Varg J (1974) Transhepatic catheterization and obliteration of the coronary vein in patients with portal hypertension and esophageal varices. N Engl J Med 291:646–649
Bean WJ, Smith SL, Mahorner HR (1973) Equipment for non-operative removal of biliary tract stones. Radiology 107:452–453
Virkkula L, Eerola S (1975) Use of omental pedicle for treatment of bronchial fistula after lower lobectomy. Scand J Thorac Cardiovasc Surg 9:287–290
Tatsumi A, Kitano M, Kou S, Tanaka F, Kou T (1990) Analysis of questionnaire on filling with omental pedicle for empyemasecond report (in Japanese). J Jpn Assn Thorac Surg 38:1812
Salmon CJ, Ponn RB, Westcott JL (1990) Endobronchial vascular occlusion coils for control of a large parenchymal bronchopleural fistula. Chest 98:233–234
Ponn RB, D’Agostino RS, Stern H, Westcott JK (1993) Treatment of peripheral bronchopleural fistulas with endobronchial occlusion coils. Ann Thorac Surg 56:1343–1347
Yasuda Y, Mori A, Kato H, Fujino S, Asakura S (1991) Intrathoracic fibrin glue for postoperative pleuropulmonary fistula. Ann Thorac Surg 51:242–244
Uchida A, Klein E (1985) Activation of human blood lymphocytes and monocytes by the streptoccocal preparation, OK-432. Immunol Lett 10:177
Le J, Vilchek J (1987) Tumor necrosis factor and interleukin-1: cytokines with multiple overlapping biological activities. Lab Invest 56:234–248
Shimokado K, Raines EW, Madtes DK, Barret TB, Benditt EP, Ross R (1985) A significant part of macrophage-derived growth factor necrosis of at least two forms of PDGF. Cell 43:277–286
Ignotz RA, Mussague J (1987) Cell adhesion protein receptors as targets for transforming growth factor-beta action. Cell 51: 189–197
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Uchida, T., Wada, M., Sakamoto, J. et al. Treatment for empyema with bronchopleural fistulas using endobronchial occlusion coils: Report of a case. Surg Today 29, 186–189 (1999). https://doi.org/10.1007/BF02482248
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02482248