"All things must pass" - Cutaneous migration of an endobronchial valve.

Abstract

The Zephyr (PulmonX Inc., Redwood, CA) endobronchial valve (EBV), predominantly designed for lung volume reduction in emphysema, can also be used to close a spontaneous or post-operative prolonged air leak (PAL). We describe a previously unreported complication of cutaneous migration of an EBV, inserted for management of a PAL from a postoperative bronchopleural fistula (BPF), in a 62-year-old male following a right upper lobe posterior-apical (S1,2) segmentectomy. His PAL resulted in a chronic empyema which failed to respond to surgical debridement, anterior cavernostomy and pectoral myoplasty. Bronchoscopic closure of the air leak by EBV insertion resulted in clinical improvement but there was a residual chronic wound sinus through which the patient reported protrusion of a foreign body that was causing irritation. It was the EBV. We hypothesise that the BPF healed beneath the EBV causing it to dislodge but its route to the skin remains a mystery.

• Authors: Michelle Lee, Ralitsa Baranowski, David Gammon, Joanne Hargrave, David Waller
• Journal: JRSM open (JRSM Open) Vol. 13 Issue 1 Pg. 20542704221074148 (Jan 2022) ISSN: 2054-2704 [Print] England
• PMID: 35633774 (Publication Type: Case Reports)
• Copyright: © 2022 The Author(s).