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Endobronchial valve placement in secondary pneumothorax related to allergic bronchopulmonary aspergillosis

Deepa Ramadurai1, David M DiBardino2, Gina Hong1

  • 1Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Respiratory Medicine Case Reports
|November 25, 2021
PubMed

Insights

Endobronchial valves (EBVs) offer a novel treatment for persistent air leaks (PAL) following secondary pneumothorax in patients with allergic bronchopulmonary aspergillosis (ABPA). This case study highlights successful EBV use in a complex ABPA patient with a bronchopleural fistula.

Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Interventional Pulmonology

Background:

  • Secondary pneumothorax is a rare but serious complication in patients with allergic bronchopulmonary aspergillosis (ABPA) and bronchiectasis.
  • Persistent air leak (PAL) is defined as an ongoing air communication with the pleural space despite drainage, often requiring invasive interventions.

Observation:

  • The study presents a case of a male patient with ABPA on high-dose steroids experiencing a secondary pneumothorax with a large bronchopleural fistula (BPF).
  • The patient developed a persistent air leak (PAL) unresponsive to initial chest tube management.

Findings:

  • Endobronchial valves (EBVs) were successfully utilized to manage the persistent air leak (PAL) in this complex patient.
  • This represents a potentially effective, less invasive treatment option for PAL in the context of ABPA and BPF.

Implications:

  • Endobronchial valve therapy may offer a viable alternative to surgery or prolonged drainage for persistent air leaks in specific inflammatory lung conditions.
  • Further research, including randomized controlled trials, is warranted to establish the efficacy of EBVs for PAL in patients with underlying inflammatory pulmonary diseases like ABPA.
Keywords:
Allergic bronchopulmonary aspergillosisBronchopleural fistula managementPersistent air leak managementSecondary pneumothorax managementSendobronchial valve placement

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