Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of RUL Bronchopleural Fistula Occluded by Flexible Bronchoscope with Endobronchial Watanabe Spigot (EWS)

기관지내시경을 통한 Endobronchial Watanabe Spigot (EWS) 삽입으로 치료한 기관지흉막루 1례

  • Choi, Young In (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Cho, Jin Hui (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Shim, Jin Young (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Sheen, Seung Soo (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Oh, Yoon Jung (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Park, Joo Hun (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Hwang, Sung Chul (Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine) ;
  • Lee, Sung Soo (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine)
  • 최영인 (아주대학교 의과대학 호흡기학교실) ;
  • 조진희 (아주대학교 의과대학 호흡기학교실) ;
  • 심진영 (아주대학교 의과대학 호흡기학교실) ;
  • 신승수 (아주대학교 의과대학 호흡기학교실) ;
  • 오윤정 (아주대학교 의과대학 호흡기학교실) ;
  • 박주헌 (아주대학교 의과대학 호흡기학교실) ;
  • 황성철 (아주대학교 의과대학 호흡기학교실) ;
  • 이성수 (아주대학교 의과대학 흉부외과학교실)
  • Received : 2005.01.26
  • Accepted : 2005.03.30
  • Published : 2005.04.30
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Abstract

An 86 year old woman was admitted complaining of dyspnea and right pleuritic pain with a 5 week durations. A physical examination, chest X-ray, and diagnostic thoracentesis upon admission revealed findings consistent with severe pneumonia and empyema on the right lung. Despite the insertion of a chest tube and negative suction via Emersion pump, the continuous air leakage was sustained, and a bronchopleural fistula (BPF) was found on the chest-CT. A flexible bronchoscopic occlusion with an Endobronchial Watanabe Spigot (EWS) was performed after 56 days of admission. An 5 mm diameter EWS was successfully inserted into the anterior segmental bronchus of the right upper lobe by flexible bronchoscope. There was no aAir leakage detected after this procedure. The patient was discharged 30 days after the EWS occlusion.

기관지흉막루는 수술적 치료를 고려해야 하나 대부분의 환자들이 전신상태가 불량하고 기저질환으로 인해 수술을 시행할 수 없는 경우가 많다. 이런 환자들에게 있어서 굴곡성 기관지내시경을 이용하여 누공을 폐쇄시키는 다양한 방법들이 시도되고 있다. 저자들은 폐렴 및 농흉이 동반된 고령의 환자에서 흉관삽입 후 발생한 원위부 기관지 흉막루를 굴곡성 기관지내시경을 이용한 EWS 삽입으로 치료에 성공한 1례가 있어 보고하는 바이다.

Keywords

References

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