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Bronchopleural fistula (BPF) is a pathological connection between the bronchial tree and pleural space usually formed as a result of local or systemic illness affecting pulmonary or pleural tissue. It is associated with significant morbidity and prolonged stay in the hospital. We present the case of a 33-year-old male with multiple sclerosis with m...
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... had been bedbound for more than a year. He presented to us with respiratory failure from pneumonia and required prolonged mechanical ventilation (MV) and tracheostomy. The patient was ventilated with low tidal volume (6 mL/kg ideal body weight) MV, and plateau pressure was maintained below 30. He developed pneumothorax which remained unresolved (Fig. 1) after chest tube insertion suggesting BPF. A high-resolution CT chest confirmed the presence of a 10 × 10 cm pocket of pneumothorax in the left upper pleural cavity with a compressed and poorly ventilated left lower lobe of the lung. BPF failed to heal with medical management with oxygen therapy, chest tube evacuation, and appropriate ...
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