
An Intricate Case of Pyopneumothorax with Trapped Right Lung Requiring Swift Adaptation and Multidisciplinary Collaboration
UD01-UD03
Correspondence
Dr. Jayant Bhatia,
Resident, Department of Anaesthesia, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune-411018, Maharashtra, India.
E-mail: jayant.bhatia0314@gmail.com
Pulmonary Tuberculosis (PTB) is a significant cause of morbidity, especially in patients with underlying health conditions. The present case highlights the complex management in a patient with intricate medical history, marked by tuberculosis, multiple Intercostal Chest Drain (ICD) procedures, and pyopneumothorax with long-standing diabetes mellitus and a history of smoking, adding to the uniqueness of the case. The authors present a case of a 67-year-old male, admitted for a right Pneumonectomy (PE) due to a complex combination of pyopneumothorax, right trapped lung and post-decortication status. However, due to the fragile nature of the tissue and the existence of vascular adhesions, it was decided to choose “physiological lung exclusion” by separating the affected lung from the tracheobronchial tree by cutting the bronchus and tying off the pulmonary artery, without removing any lung tissue, while keeping the pulmonary veins intact. The present report highlights the challenges faced, the multidisciplinary approach employed, and the successful surgical outcome, underscoring the importance of collaborative management.