Successful treatment of a persistent air leak with an endobronchial valve in a 17‐year‐old patient with necrotizing pneumonia

Abstract

Abstract Pleural empyema is a severe condition associated with high morbidity and mortality. Treatment usually consists of pleural drainage with chest tube or surgery, in combination with antimicrobial treatment. Severe pneumonia can evolve in a necrotizing pneumonia, given a higher susceptibility to the occurrence of bronchopleural fistulas with persistent air leaks. This complicates recovery, and surgery may not always be the optimal treatment. We present a case involving a 17‐year‐old female patient who experienced a post‐operative persistent air leak due to necrotizing pneumonia after video‐assisted thoracic surgery decortication for empyema, which was successfully treated using an endobronchial valve. After 6 months the valve was removed without complications. Follow‐up imaging and lung function revealed a limited area of atelectasis and minimal pleural thickening with normal lung volumes.

Keywords

• bronchopleural fistula
• necrotizing pneumonia
• persistent air leak
• unidirectional endobronchial valve