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Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report
BACKGROUND: A bronchial fistula is a relatively rare and potentially fatal complication after lung transplantation. Thoracic surgeons and pulmonologists often face challenges when selecting treatment options. We herein report an exceptional case of intrabronchial migration of a nonabsorbable hemosta...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8110655/ https://www.ncbi.nlm.nih.gov/pubmed/33970364 http://dx.doi.org/10.1186/s40792-021-01200-z |
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author | Nobori, Yuya Sato, Masaaki Hirata, Yasutaka Yamauchi, Haruo Konoeda, Chihiro Kitano, Kentaro Nakajima, Jun |
author_facet | Nobori, Yuya Sato, Masaaki Hirata, Yasutaka Yamauchi, Haruo Konoeda, Chihiro Kitano, Kentaro Nakajima, Jun |
author_sort | Nobori, Yuya |
collection | PubMed |
description | BACKGROUND: A bronchial fistula is a relatively rare and potentially fatal complication after lung transplantation. Thoracic surgeons and pulmonologists often face challenges when selecting treatment options. We herein report an exceptional case of intrabronchial migration of a nonabsorbable hemostatic agent, which had been placed around the pulmonary artery at the time of lung transplantation, through a bronchial fistula. CASE PRESENTATION: A 61-year-old man developed respiratory distress 1 year after left single-lung transplantation for idiopathic interstitial pneumonia. Bronchoscopic examination revealed an apparent foreign body protruding from the mediastinum into the distal site of the bronchial anastomosis. The foreign body was easily removed bronchoscopically and appeared to be a hemostatic agent that had been placed during the previous lung transplantation. The patient developed a similar clinical episode and finally developed hemoptysis. Computed tomography revealed a foreign body located between the bronchus and pulmonary artery, partially protruding into the bronchial lumen. Given the possibility of a bronchopulmonary arterial fistula, surgical treatment was performed. The foreign body was located between the bronchus and left pulmonary artery and was easily removed. Multiple bronchial fistulas were found, and all were closed with direct sutures. Bypass grafting of the left pulmonary artery was then performed, initially with a homograft but eventually with an extended polytetrafluoroethylene graft. The patient was finally discharged 5 months after the surgery. CONCLUSION: We experienced an extremely rare case of intrabronchial migration of hemostatic agents used during the previous lung transplantation through a bronchial fistula, which were successfully managed by direct bronchial closure and bypass grafting of the left pulmonary artery. |
format | Online Article Text |
id | pubmed-8110655 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-81106552021-05-13 Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report Nobori, Yuya Sato, Masaaki Hirata, Yasutaka Yamauchi, Haruo Konoeda, Chihiro Kitano, Kentaro Nakajima, Jun Surg Case Rep Case Report BACKGROUND: A bronchial fistula is a relatively rare and potentially fatal complication after lung transplantation. Thoracic surgeons and pulmonologists often face challenges when selecting treatment options. We herein report an exceptional case of intrabronchial migration of a nonabsorbable hemostatic agent, which had been placed around the pulmonary artery at the time of lung transplantation, through a bronchial fistula. CASE PRESENTATION: A 61-year-old man developed respiratory distress 1 year after left single-lung transplantation for idiopathic interstitial pneumonia. Bronchoscopic examination revealed an apparent foreign body protruding from the mediastinum into the distal site of the bronchial anastomosis. The foreign body was easily removed bronchoscopically and appeared to be a hemostatic agent that had been placed during the previous lung transplantation. The patient developed a similar clinical episode and finally developed hemoptysis. Computed tomography revealed a foreign body located between the bronchus and pulmonary artery, partially protruding into the bronchial lumen. Given the possibility of a bronchopulmonary arterial fistula, surgical treatment was performed. The foreign body was located between the bronchus and left pulmonary artery and was easily removed. Multiple bronchial fistulas were found, and all were closed with direct sutures. Bypass grafting of the left pulmonary artery was then performed, initially with a homograft but eventually with an extended polytetrafluoroethylene graft. The patient was finally discharged 5 months after the surgery. CONCLUSION: We experienced an extremely rare case of intrabronchial migration of hemostatic agents used during the previous lung transplantation through a bronchial fistula, which were successfully managed by direct bronchial closure and bypass grafting of the left pulmonary artery. Springer Berlin Heidelberg 2021-05-10 /pmc/articles/PMC8110655/ /pubmed/33970364 http://dx.doi.org/10.1186/s40792-021-01200-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Case Report Nobori, Yuya Sato, Masaaki Hirata, Yasutaka Yamauchi, Haruo Konoeda, Chihiro Kitano, Kentaro Nakajima, Jun Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report |
title | Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report |
title_full | Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report |
title_fullStr | Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report |
title_full_unstemmed | Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report |
title_short | Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report |
title_sort | intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8110655/ https://www.ncbi.nlm.nih.gov/pubmed/33970364 http://dx.doi.org/10.1186/s40792-021-01200-z |
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