A case of prolonged pneumothorax of a destroyed lung successfully wrapped with pedicled intercostal muscle flap

Abstract

We experienced a case of prolonged pneumothorax with complications involving destroyed lung in which wrapping by a pediculed intercostal muscle flap was useful. Regarding the case, a 62-year-old man had been admitted to another hospital for integration dysfunction syndrome. However, he developed spontaneous pneumothorax in the left lung in May 2004. Accordingly, he was admitted to our hospital through introduction. We inserted a drain into the thoracic cavity and performed suction drainage continuously for two weeks. However, air leak did not resolve. We operated on him on the fifteenth day since he was admitted to our hospital. During the operation, we found a pulmonary fistula about 5 mm in diameter in the left lower lobe S⁹. Because the pulmonary fistula was complicated with destroyed lung, we wrapped it with a pedicled intercostal muscle flap. The postoperative course has been good, and there has been no recurrence of pneumothorax to date. The destroyed lung is a state in which the structure and function no longer exist. Due to poor circulation and anoxia, healing of the wound is delayed. Therefore, we thought that wrapping by tissue rich in blood flow was useful.