Delayed bronchial perforation after bulla cauterization with soft coagulation system

Abstract Background Soft coagulation is widely used for hemostasis because of its significant advantage in inducing tissue coagulation and denaturation without carbonization. However, a few cases of airway damage have been reported at the site, where soft coagulation was directly applied. Case prese...

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Autores principales:	Sakiko Kumata, Katsunari Matsuoka, Shinjiro Nagai, Mitsuhiro Ueda, Yoshinori Okada, Yoshihiro Miyamoto
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Soft coagulation system Thermal injury Bronchial perforation Bronchopleural fistula Surgery RD1-811
Acceso en línea:	https://doaj.org/article/630bb42eabd443b482ada5d23a2afe61
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spelling	oai:doaj.org-article:630bb42eabd443b482ada5d23a2afe612021-11-21T12:31:52ZDelayed bronchial perforation after bulla cauterization with soft coagulation system10.1186/s40792-021-01327-z2198-7793https://doaj.org/article/630bb42eabd443b482ada5d23a2afe612021-11-01T00:00:00Zhttps://doi.org/10.1186/s40792-021-01327-zhttps://doaj.org/toc/2198-7793Abstract Background Soft coagulation is widely used for hemostasis because of its significant advantage in inducing tissue coagulation and denaturation without carbonization. However, a few cases of airway damage have been reported at the site, where soft coagulation was directly applied. Case presentation We encountered an unusual case of delayed perforation of the intermediate bronchial trunk observed on 24 days after cauterization of the right S6 bulla adjacent to the bronchus. Chest computed tomography revealed a large fistula between the intermediate bronchial trunk and the cauterized bulla in the right S6. Bronchoscopy showed a large fistula at the membranous portion of the intermediate bronchial trunk. We presumed that the bronchial perforation resulted from thermal damage to the intermediate bronchial trunk during bulla cauterization and the bronchial perforation induced infection in the bulla. Resection of the infectious bulla and the intermediate bronchial trunk, followed by end-to-end bronchial anastomosis and a pedicled intercostal muscle flap coverage, was performed. Conclusions The severe airway damage resulting in perforation developed even without direct contact between the electrode tip and the bronchial wall, provoking the need for special attention to the duration of cauterization and location, where it is used.Sakiko KumataKatsunari MatsuokaShinjiro NagaiMitsuhiro UedaYoshinori OkadaYoshihiro MiyamotoSpringerOpenarticleSoft coagulation systemThermal injuryBronchial perforationBronchopleural fistulaSurgeryRD1-811ENSurgical Case Reports, Vol 7, Iss 1, Pp 1-4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Soft coagulation system Thermal injury Bronchial perforation Bronchopleural fistula Surgery RD1-811
spellingShingle	Soft coagulation system Thermal injury Bronchial perforation Bronchopleural fistula Surgery RD1-811 Sakiko Kumata Katsunari Matsuoka Shinjiro Nagai Mitsuhiro Ueda Yoshinori Okada Yoshihiro Miyamoto Delayed bronchial perforation after bulla cauterization with soft coagulation system
description	Abstract Background Soft coagulation is widely used for hemostasis because of its significant advantage in inducing tissue coagulation and denaturation without carbonization. However, a few cases of airway damage have been reported at the site, where soft coagulation was directly applied. Case presentation We encountered an unusual case of delayed perforation of the intermediate bronchial trunk observed on 24 days after cauterization of the right S6 bulla adjacent to the bronchus. Chest computed tomography revealed a large fistula between the intermediate bronchial trunk and the cauterized bulla in the right S6. Bronchoscopy showed a large fistula at the membranous portion of the intermediate bronchial trunk. We presumed that the bronchial perforation resulted from thermal damage to the intermediate bronchial trunk during bulla cauterization and the bronchial perforation induced infection in the bulla. Resection of the infectious bulla and the intermediate bronchial trunk, followed by end-to-end bronchial anastomosis and a pedicled intercostal muscle flap coverage, was performed. Conclusions The severe airway damage resulting in perforation developed even without direct contact between the electrode tip and the bronchial wall, provoking the need for special attention to the duration of cauterization and location, where it is used.
format	article
author	Sakiko Kumata Katsunari Matsuoka Shinjiro Nagai Mitsuhiro Ueda Yoshinori Okada Yoshihiro Miyamoto
author_facet	Sakiko Kumata Katsunari Matsuoka Shinjiro Nagai Mitsuhiro Ueda Yoshinori Okada Yoshihiro Miyamoto
author_sort	Sakiko Kumata
title	Delayed bronchial perforation after bulla cauterization with soft coagulation system
title_short	Delayed bronchial perforation after bulla cauterization with soft coagulation system
title_full	Delayed bronchial perforation after bulla cauterization with soft coagulation system
title_fullStr	Delayed bronchial perforation after bulla cauterization with soft coagulation system
title_full_unstemmed	Delayed bronchial perforation after bulla cauterization with soft coagulation system
title_sort	delayed bronchial perforation after bulla cauterization with soft coagulation system
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/630bb42eabd443b482ada5d23a2afe61
work_keys_str_mv	AT sakikokumata delayedbronchialperforationafterbullacauterizationwithsoftcoagulationsystem AT katsunarimatsuoka delayedbronchialperforationafterbullacauterizationwithsoftcoagulationsystem AT shinjironagai delayedbronchialperforationafterbullacauterizationwithsoftcoagulationsystem AT mitsuhiroueda delayedbronchialperforationafterbullacauterizationwithsoftcoagulationsystem AT yoshinoriokada delayedbronchialperforationafterbullacauterizationwithsoftcoagulationsystem AT yoshihiromiyamoto delayedbronchialperforationafterbullacauterizationwithsoftcoagulationsystem
_version_	1718418946832465920

Delayed bronchial perforation after bulla cauterization with soft coagulation system

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