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Omentopexy for empyema due to lung fistula following lobectomy. A case report

Y Nonami1, S Ogoshi

  • 1Department of Surgery II, Kochi Medical School, Nankoku, Japan.

Insights

A persistent air leak after lung surgery, diagnosed via chest drain and fluid culture, was successfully treated with omentopexy. Postoperative monitoring is crucial for managing complications following pulmonary lobectomy.

Area of Science:

  • Thoracic Surgery
  • Surgical Complications
  • Pulmonary Medicine

Background:

  • Pulmonary lobectomy can lead to complications such as persistent air leaks, known as sustained pulmonary fistulas.
  • Early and accurate diagnosis is essential for effective management of post-lobectomy air leaks.

Observation:

  • A case of sustained pulmonary fistula following lung surgery presented with continuous air leak via chest drain.
  • Drainage fluid analysis revealed a positive culture, indicating an infectious component.

Findings:

  • The sustained pulmonary fistula was successfully treated with a third re-operation involving omentopexy via median sternotomy.
  • This surgical approach effectively closed the fistula and resolved the air leak.

Implications:

  • Sustained pulmonary fistulas require vigilant postoperative monitoring, including chest radiography and bronchial fiberoscopy.
  • Infection assessment of drainage fluid is critical for guiding precise diagnosis and therapeutic strategies.
  • Omentopexy is a viable surgical option for managing complex cases of sustained pulmonary fistulas post-lobectomy.

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