Chest

Chest

Volume 114, Issue 6, December 1998, Pages 1781-1784
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Selected Reports
Bronchopleural Fistula Resulting From the Use of a Thoracic Vent: A Case Report and Review

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Pneumothorax is defined as the presence of gas or air within the pleural space. Standard treatment is usually based on the evacuation of the gas by various methods. The thoracic vent is a relatively new device used in the treatment of pneumothorax. This report focuses on the first major complication, as far as is known, associated with the use of a thoracic vent.

Section snippets

Case Report

A 35-year-old African-American man presented to the emergency department with complaints of shortness of breath and right-sided pleuritic chest pain. These symptoms started approximately 2 weeks prior to presentation after he was kicked in the chest during an altercation. The pain and dyspnea became acutely worse the day of presentation and led him to seek treatment at the emergency department (ED). Past medical and surgical histories included multiple stab wounds to the left area of the thorax

Discussion

Woodruff8 first described a bronchopleural fistula as a sinus tract that develops between the bronchus and the pleural space as a consequence of trauma or a necrotizing infection. The distinction between a pneumothorax and a bronchopleural fistula is that in the former the communication is between a peripheral airspace (ie, bleb) and the pleura instead of between a bronchiole or bronchus and the pleura.9 Historically, the most common cause oí bronchopleural fistula was a necrotizing pneumonia;

Conclusion

In the proper hands, the thoracic vent is an excellent addition to tube thoracostomy and needle decompression in the treatment of simple pneumothorax. Appropriate surgical consultation may have avoided a morbid complication in what was probably an inappropriate use of this treatment option.

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Copyright © 1998 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.