Shen L, Jiang YH, Dai XY. Successful surgical treatment of bronchopleural fistula caused by severe pulmonary tuberculosis: A case report and review of literature. World J Clin Cases 2023; 11(10): 2282-2289 [PMID: 37122506 DOI: 10.12998/wjcc.v11.i10.2282]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 6, 2023; 11(10): 2282-2289 Published online Apr 6, 2023. doi: 10.12998/wjcc.v11.i10.2282
Successful surgical treatment of bronchopleural fistula caused by severe pulmonary tuberculosis: A case report and review of literature
Lei Shen, Yu-Hui Jiang, Xi-Yong Dai
Lei Shen, Yu-Hui Jiang, Xi-Yong Dai, Department of Thoracic Surgery, Wuhan Pulmonary Hospital, Wuhan 430030, Hubei Province, China
Author contributions: Shen L was responsible for patient care and wrote the first draft of the manuscript; Jiang YH contributed to the diagnosis and treatment of the patient and to the revision of the manuscript; Dai XY supervised the patients’ care, conceptualized the study, and revised the manuscript; all authors read and approved the final manuscript.
Supported bygrants of Wuhan Municipal Health Commission, No. WX20Z30.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: December 22, 2022 Peer-review started: December 22, 2022 First decision: January 20, 2023 Revised: February 1, 2023 Accepted: March 9, 2023 Article in press: March 9, 2023 Published online: April 6, 2023 Processing time: 98 Days and 6.4 Hours
Abstract
BACKGROUND
Bronchopleural fistula (BPF) is a relatively rare, but severe complication of pulmonary tuberculosis. It is associated with significant mortality; however, its management remains a major therapeutic challenge.
CASE SUMMARY
We present a 24-year-old man with BPF resulting from severe pulmonary tuberculosis combined with mixed infections. The damaged right upper lobe and concomitant empyema were demonstrated via computed tomography. After undergoing open-window thoracostomy and tuberculosis treatment for 4 mo, decortication and right upper lobectomy were subsequently performed, leading to the resolution of tuberculosis and other concurrent pulmonary infections. Follow-up, 6 mo after surgery, failed to reveal any evidence of infection recurrence resulting in a good prognosis.
CONCLUSION
The disease course of tuberculous BPF is particularly challenging. Surgical intervention serves as an effective and safe therapeutic strategy for BPF.
Core Tip: Bronchopleural fistula (BPF) is a relatively rare but severe complication of pulmonary tuberculosis. However, no consensus has been reached on the ideal treatment modality. This article presents a patient with a BPF resulting from severe pulmonary tuberculosis accompanied by mixed infections. Strict preoperative evaluation of surgical indications, including standard preoperative anti-tuberculosis treatment and controlling the infection through an open-window thoracostomy during surgery, can achieve a satisfactory long-term prognosis for the treatment of BPF through this three-pronged approach.
