Successful treatment of post-operative peripheral bronchopleural fistulas using endobronchial Watanabe spigots

Post-operative peripheral bronchopleural fistulas (BPF) are sometimes caused by post-operative pneumonia and empyema. Conservative treatment options such as administration of antibiotics and chest tube drainage can have limited outcomes in certain cases. Bronchial occlusion is an effective treatment option if the target bronchi for BPF are identified. This case study describes a successful bronchial occlusion for peripheral BPF with endobronchial Watanabe spigots (EWSs) and a digital drainage system. This case involved a 70-year-old man who developed a post-operative peripheral BPF after a left upper lobectomy. Bronchial occlusion with EWS was performed because the target bronchi responsible for BPF were clearly detected by a chest computerized tomography scan. The effectiveness of the occlusion was confirmed with the use of a digital drainage system immediately after the procedure was completed. The chest tube was removed one week following the bronchial occlusion procedure.