Development of alveolar-pleural fistula during hepatectomy: A case report
10.17085/apm.2019.14.4.456
- Author:
Jun Hyun KIM
1
;
Sunghyeok PARK
;
Ji Yeon KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea. jy67925@naver.com
- Publication Type:Case Report
- Keywords:
Fistula;
Hepatectomy;
One lung ventilation;
Pleural effusion
- MeSH:
Aged;
Exudates and Transudates;
Fistula;
Hepatectomy;
Humans;
Liver;
Lung;
Male;
One-Lung Ventilation;
Pleural Effusion;
Pneumonia;
Pneumothorax;
Respiratory Insufficiency;
Suction;
Thoracostomy
- From:Anesthesia and Pain Medicine
2019;14(4):456-459
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: An Alveolar-pleural fistula is communication between the alveoli and the pleural space that may result in intractable pneumothorax, severe infection, respiratory failure, physical weakness, and even death.CASE: A 70-year-old male underwent right hepatectomy with a cystic mass of the liver. During the operation, peak airway pressure abruptly increased and a serous fluid was regurgitated through the endotracheal tube. Lung isolation was immediately performed with a double-lumen endotracheal tube. Approximately 1,000 ml of exudate was drained through endotracheal tube. Thoracostomy was performed at right lung. Analysis of fluid from endotracheal tube and pleural effusion consistent with parapneumonic effusion.CONCLUSIONS: We presented a case of alveolar-pleural fistula caused by pneumonia presenting with massive exudate fluid regurgitated from the endotracheal tube that was managed with bronchial suction, lung isolation, and thoracostomy and improved without surgical repair of the fistula.
