Das Leck in der Lunge: Bronchoskopische Ventilimplantation zur Behandlung einer persistierenden bronchopleuralen Fistel

Zusammenfassung

Das Vorhandensein einer bronchopleuralen Fistel ist mit einem erhöhtem Morbiditäts- und Mortalitätsrisiko verbunden. Die Therapie umfasst neben intrathorakaler Drainage und Antibiose den Fistelverschluss, welcher im Regelfall eine chirurgische Domäne darstellt. Bei Pat. mit eingeschränkter Lungenfunktion ist in vielen Fällen eine minimal-invasive Alternative wünschenswert bzw. erforderlich. Wir berichten über eine 62-jährige Pat. mit schwerer COPD, die aufgrund eines Lungenabszesses zur Aufnahme gelangte und eine bronchopleurale Fistel entwickelte. Die Behandlung umfasste neben einer antibiotischen Therapie die Implantation endobronchialer Einwegventile, welche zum Fistelverschluss und schließlich zur Rekonvaleszenz führte.

Abstract

Patients with bronchopleural fistula are at an increased risk of morbidity and mortality. Treatment of the air leak includes intrathoracic drainage, antibiotic therapy and closure of the fistula, which conventionally has been performed via surgical means. In patients with limited respiratory capacity, less-invasive alternatives are required. Here we report on a 62-year-old patient with underlying severe COPD, who was admitted with a lung abscess and consecutively developed a persistent bronchopleural fistula. Treatment involved antibiotic therapy and endobronchial one-way valve placement, which resulted in termination of the air leak and full recovery.

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