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Successful endoscopic closure of alveolar-pleural fistula due to Aspergillus empyema using a ventricular septal
Zeqin Fan1, Xiaoxian Huang1, Lihui Zhang1
1Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital of Yunnan University, Key Laboratory of Respiratory Disease Research of Department of Education of Yunnan Province, Kunming, PR China.
Abstract:
We report a patient with fever and cough for 2 months who was finally given a diagnosis of alveolar-pleural fistula due to aspergillus empyema. We successfully closed the alveolar-pleural fistula with a ventricular septal defect occluder through bronchoscopy. Endoscopic closure of an alveolar-pleural fistula with ventricular septal defect occluder is worth being explored.
Insights
A persistent cough and fever were diagnosed as an alveolar-pleural fistula caused by aspergillus empyema. Bronchoscopic closure using a ventricular septal defect occluder proved successful, offering a new treatment avenue.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Infectious Diseases
Background:
- Alveolar-pleural fistula is a rare but serious complication, often associated with persistent air leak and infection.
- Aspergillus empyema presents a significant challenge in managing thoracic infections, potentially leading to complex fistulous communications.
Observation:
- A patient presented with a two-month history of persistent fever and cough, indicative of a chronic respiratory condition.
- Diagnostic workup revealed an alveolar-pleural fistula secondary to aspergillus empyema.
Findings:
- Successful endoscopic closure of the alveolar-pleural fistula was achieved using a ventricular septal defect occluder via bronchoscopy.
- This minimally invasive approach effectively sealed the abnormal communication between the alveoli and the pleural space.
Implications:
- Endoscopic management of alveolar-pleural fistulas with readily available devices like ventricular septal defect occluders represents a promising, less invasive alternative to surgical intervention.
- Further investigation into this technique could refine treatment protocols for complex thoracic fistulas and empyema complications.
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