IJSR - International Journal of Scientific Research

Abinav Dagar; Nidhi Dahiya; Sumit Bharti

Volume : VIII, Issue : VIII, August - 2019

Management of Recurrent Pneumothorax and Broncho–Pleural Fistula By Flexible Bronchoscopy guided instillation of Silver Nitrate

Abinav Dagar, Nidhi Dahiya, Sumit Bharti

Abstract :

Introduction: A Pneumothorax is a condition characterized by the accumulation of air in the pleural space and associated secondary collapse of the surrounding lung . Pneumothoraces can be mainly divided into Traumatic pneumothorax and Spontaneous Pneumothorax. Spontaneous pneumothorax is further subclassiﬁed into either a primary spontaneous pneumothorax or secondary spontaneous pneumothorax . They are at times complicated by a onchopleural fistula or a persistent air leak needing prolonged chest tube drainage. In patients who are poor surgical candidates Non–surgical treatment of persistent oncho–pleural fistula is performed , but the ideal method of closure is surgery. Case Report : The current article is regarding a middle aged male patient who came to the department with left sided pneumothorax and Intercostal drainage tube in situ. He had a history of recurrent pneumothorax and a persistent Broncho Pleural Fistula which was closed non surgically using silver nitrate in our department. Conclusion: Pneumothorax is a common condition and at times it is complicated by the presence of oncho–pleural fistula which in turn leads to persistence of ICD tube for a long time in the patient there by affecting the quality of life of the patients and additional chance of secondary infection. Since long surgery was considered as the only option but in patients who are unfit for surgery, Bronchoscopy guided Silver nitrate instillation and Broncho Pleural Fistula closure is an cheaper and less inasive option.