Delayed Pneumothorax Post Transbronchial Biopsy: A Case Report.

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Case Reports

Background:

• Bronchoscopy with transbronchial lung biopsy (TBB) is a common procedure for diagnosing lung conditions.
• Pneumothorax (PTX) is a known complication, typically occurring acutely post-procedure.
• Delayed PTX (>4 hours post-procedure) is a rare but significant complication.

Observation:

• A 71-year-old male with metastatic malignancy on steroids developed delayed PTX 48 hours after TBB.
• Initial chest X-ray post-procedure was unremarkable for PTX.
• The patient presented with shortness of breath and hypoxemia, leading to diagnosis of left-sided PTX.

Findings:

• The patient's delayed PTX was likely related to the TBB, possibly due to impaired wound healing from underlying malignancy and steroid use.
• Factors such as chronic inflammation, steroid therapy, and malignancy can contribute to delayed visceral pleural defect healing.
• This case underscores the possibility of delayed PTX even in patients initially stable post-procedure.

Implications:

• Healthcare providers should maintain a high index of suspicion for delayed PTX in patients with risk factors presenting with respiratory symptoms days after TBB.
• Further research into risk stratification and optimal post-procedure surveillance for delayed PTX is warranted.
• Prompt recognition and management of delayed PTX are crucial for favorable patient outcomes.