Repair of tracheal aspergillosis perforation causing tension pneumothorax.

Gonzalez, Michel; Ma Tooh, Mengu; Krueger, Thorsten; Ris, Hans-Beat; Letovanec, Igor; Wang, Yabo; Lovis, Alban · Ann Thorac Surg · 2013

case_report · Level V

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Abstract

Tracheobronchial aspergillosis is a rare entity mainly observed in immune-compromised patients or those who have undergone transplantation. It may cause airway ulcerations or bleeding. We report the case of a 17-year-old patient receiving chemotherapy for acute lymphoblastic leukemia who presented with right-sided tension pneumothorax. Chest tube drainage revealed a massive air leak without reexpansion of the lung, and bronchoscopy showed a 15- × 15-mm defect of the distal trachea related to aspergillosis infection. The defect was closed by an intrathoracic transposition of a pedicled latissimus dorsi muscle flap, which was sutured into the debrided defect followed by temporary endotracheal stenting and antifungal medication.

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