2016 Volume 38 Issue 6 Pages 505-509
Background. Pneumothorax can occur as a complication of late-stage nontuberculous mycobacterial infection and is often difficult to cure. We herein report a case in which intractable pneumothorax occurring as a complication of nontuberculous mycobacterial infection was successfully treated by occluding the affected bronchus using an endobronchial Watanabe spigot (EWS) with the guide-sheath curette method. Case. The patient was an 88-year-old woman with a chief complaint of dyspnea. A chest radiograph obtained six years earlier had shown an abnormal shadow. A subsequent detailed examination led to a diagnosis of pulmonary Mycobacterium avium complex infection. Since then, the patient had been followed up by a local doctor. She had recently visited the local doctor because of dyspnea, and a chest radiograph showed right-sided pneumothorax. Therefore, she was referred to our hospital. Continuous air drainage failed to improve the condition, and on the 17th day of admission, an EWS was placed in the middle lobe bronchus using the guide-sheath curette method. The pneumothorax improved, and the drain was removed on the 22nd day of admission. Bronchial occlusion using an EWS with the guide-sheath curette method, in which an EWS is mounted on the tip of the probe and inserted through a guide-sheath to be placed at a target site, is minimally invasive and less time-consuming than other methods and allows complete occlusion of the culprit bronchus. Conclusion. Bronchial occlusion using an EWS with the guide-sheath curette method appears to be effective in the treatment of intractable pneumothorax caused by nontuberculous mycobacterial infection.