A Case of Successful Pleurodesis for Bilateral Pneumothorax and Pneumoperitoneum After Esophagectomy
- VernacularTitle:食道癌術後両側気胸および気腹症に対しOK-432を用いた胸膜癒着術が奏功した１例
- Author:
Yayoi SAKATOKU
1
Author Information
- From:Journal of the Japanese Association of Rural Medicine 2023;72(4):332-338
- CountryJapan
- Language:Japanese
- Abstract: The patient was an 83-year-old man who had undergone thoracoscopic subtotal esophagectomy 1 year and 6 months earlier with no evidence of recurrence. He was hospitalized for heart failure. On day 6 of hospitalization, a plain chest X-ray revealed bilateral pneumothorax and bilateral subdiaphragmatic free air, and CT showed a large amount of free air in the abdominal cavity. Gastrointestinal perforation was ruled out because of the absence of both abdominal findings and an elevated inflammatory response. Because the patient had a history of surgery for esophageal cancer, we assumed that air from the right spontaneous pneumothorax had disseminated into the contralateral thoracic and abdominal cavities. Therefore, a right chest drain was inserted. Air leakage persisted despite improvements in both collapsed lungs and the disappearance of intraperitoneal free air. No improvement was observed even after performing pleurodesis with autologous blood and glucose solution. Surgery was deemed challenging due to the patient’s low heart function; thus, pleurodesis was performed again using OK-432, which ameliorated the pneumothorax. To our knowledge, there have been no Japanese reports of pleurodesis using OK-432 for pneumothorax after esophagectomy.
