Intractable Pneumothorax Treated With Endobronchial Watanabe Spigots

Area of Science:

• Pulmonology
• Interventional Bronchoscopy
• Infectious Diseases

Background:

• Nontuberculous mycobacterial (NTM) lung disease can cause severe, intractable pneumothorax.
• Pneumothorax in this context is associated with high mortality and limited treatment options.

Observation:

• A patient presented with intractable pneumothorax secondary to NTM lung disease.
• The patient had multiple ectatic bronchi connected to a bronchopleural fistula.

Findings:

• Successful treatment of intractable pneumothorax was achieved using endobronchial Watanabe spigots (EWSs).
• Occlusion of multiple ectatic bronchi via bronchopleural fistula was critical for EWS efficacy.

Implications:

• Endobronchial Watanabe spigots represent a promising therapeutic strategy for managing intractable pneumothorax in NTM lung disease.
• This case highlights the potential of bronchoscopic interventions for complex pulmonary conditions.