Treatment of a pneumatocele in a COVID-19 patient with endobronchial valves

BMJ Case Rep. 2022 Jun 21;15(6):e250409. doi: 10.1136/bcr-2022-250409.

Abstract

A man in his 40s was admitted to his local hospital 6 days after the first vague symptoms of COVID-19. His general condition deteriorated, and he was treated in the intensive care unit but did not require mechanical ventilation. During his recovery, he experienced a cough spell, after which his dyspnoea recurred and rapidly increased. CT pulmonary angiogram showed a 10×18 cm cavitary lesion with an air-fluid level and surrounding atelectasis of the right lower lobe. A one-way valve mechanism had developed, leading to the formation of a pneumatocele. The patient was treated by occlusion of all bronchial segments of the right lower lobe with endobronchial valves, and the pneumatocele was evacuated with a pigtail catheter. The valves were removed 4 weeks after insertion, and the right lower lobe re-expanded. Six months after treatment, the patient had recovered completely and almost regained his former lung function.

Keywords: Air leaks; COVID-19; Cardiothoracic surgery; Pneumothorax; Respiratory medicine.

Publication types

  • Case Reports

MeSH terms

  • Bronchi
  • COVID-19*
  • Cysts*
  • Humans
  • Male
  • Neoplasm Recurrence, Local
  • Prostheses and Implants