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Salvage treatment of acute respiratory failure after autogenous tissue flap transplantation for chronic empyema with chest wall sinus: a case report and literature review.
- Source :
-
Journal of cardiothoracic surgery [J Cardiothorac Surg] 2024 Jan 30; Vol. 19 (1), pp. 32. Date of Electronic Publication: 2024 Jan 30. - Publication Year :
- 2024
-
Abstract
- Background: Chronic empyema with chest wall sinus is a difficult and complex disease caused by multiple causative factors. It is difficult to control local infection due to its possible combination of bronchopleural fistula (BPF) and residual bone.The relevant literature emphasizes some risk factors for empyema progression after pneumonectomy, while the correlation between empyema and BPF after pneumonectomy increases mortality by infecting the remaining lungs. After pneumonectomy, the lung function of the contralateral side is particularly important.<br />Case Presentation: This paper reports a 62-year-old male patient who underwent right pneumonectomy for squamous cell carcinoma of the lung 12 years ago and began to develop empyema with anterior chest wall sinus 3 years ago. After admission, chest computed tomography (CT) showed right pleural effusion and formation of chest wall sinus. According to his clinical symptoms and imaging examination, he was diagnosed as chronic empyema with chest wall sinus.Due to the huge residual cavity of the patient,the clinical effect of using free vastus lateralis myocutaneous flap combined with pedicled pectoralis major muscle flap to fill the abscess cavity was satisfactory,but acute respiratory failure occurred due to left lung aspiration pneumonia after operation.<br />Conclusions: After a series of treatment measures such as tracheal cannula, tracheotomy, anti-infection, maintenance of circulatory stability, and rehabilitation training, the patient was ultimately rescued and cured. Postoperative follow-up showed that the muscle flaps survived and empyema was eliminated.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Male
Middle Aged
Bronchial Fistula surgery
Empyema, Pleural complications
Empyema, Pleural surgery
Pneumonectomy adverse effects
Thoracic Wall
Respiratory Distress Syndrome etiology
Respiratory Distress Syndrome therapy
Respiratory Insufficiency etiology
Respiratory Insufficiency therapy
Salvage Therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1749-8090
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of cardiothoracic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 38291447
- Full Text :
- https://doi.org/10.1186/s13019-024-02488-2