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Imagen clínica
Manejo de fístula broncopleural mediante colocación del dispositivo Amplatzer®
Bronchopleural Fistula Management with Amplatzer™ Insertion
Ana Isabel Triviño Ramíreza,
Corresponding author
atrivi_17@hotmail.com

Autor para correspondencia.
, Mercedes Merino Sánchezb, Cayo García Polob
a Servicio de Cirugía Torácica, Hospital Universitario Puerta del Mar, Cádiz, España
b Servicio de Neumología, Hospital Universitario Puerta del Mar, Cádiz, España
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Las figuras A y B corresponden al momento de la colocaci&#243;n del sistema&#58; A&#41; Muestra la visi&#243;n a trav&#233;s del fibrobroncoscopio flexible de la correcta colocaci&#243;n del Amplatzer<span class="elsevierStyleSup">&#174;</span>&#44; una vez desplegado&#46; B&#41; Muestra la visi&#243;n a trav&#233;s de la toracostom&#237;a&#44; recogiendo el momento en el que se desprende el sistema de colocaci&#243;n del Amplatzer<span class="elsevierStyleSup">&#174;</span>&#46; Las figuras C y D muestran los resultados a los 3 meses de su colocaci&#243;n&#58; C&#41; Muestra la visi&#243;n a trav&#233;s del fibrobroncoscopio flexible del cierre de la f&#237;stula del mu&#241;&#243;n del LSD&#46; D&#41; Muestra la visi&#243;n a trav&#233;s de la toracostom&#237;a&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Paciente de 66 a&#241;os con los siguientes antecedentes&#58; empiema derecho en 2 ocasiones&#44; resecci&#243;n at&#237;pica por adenocarcinoma invasivo LII &#40;1&#44;5<span class="elsevierStyleHsp" style=""></span>cm&#41;&#44; a los 4 meses resecci&#243;n at&#237;pica por carcinoma epidermoide en LSD &#40;2&#44;5<span class="elsevierStyleHsp" style=""></span>cm&#41; y decorticaci&#243;n por toracotom&#237;a&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Diez meses despu&#233;s de la &#250;ltima intervenci&#243;n se completa la lobectom&#237;a superior derecha acompa&#241;ada de una linfadenectom&#237;a por sospecha de recidiva en LSD sobre la sutura de resecci&#243;n previa&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Durante el postoperatorio present&#243; una dehiscencia precoz del mu&#241;&#243;n bronquial&#46; A pesar de la reintervenci&#243;n&#44; se constat&#243; por fibrobroncoscopia la persistencia de f&#237;stula broncopleural &#40;FBP&#41; de 8<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mm en el mu&#241;&#243;n bronquial del LSD&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Dado el importante engrosamiento pleural&#44; el tama&#241;o de la FBP y la peque&#241;a cavidad residual apical&#44; se decidi&#243; realizar una toracostom&#237;a&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Tras plantear varias opciones terap&#233;uticas&#44; se decidi&#243; el cierre de la FBP mediante el dispositivo Amplatzer<span class="elsevierStyleSup">&#174;</span> Septal-Occluder&#44; utilizado para el cierre del foramen oval<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1&#44;2</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El procedimiento se realiz&#243; bajo sedaci&#243;n en quir&#243;fano&#46; A trav&#233;s del orificio de la toracostom&#237;a se introdujo la gu&#237;a del sistema Amplatzer<span class="elsevierStyleSup">&#174;</span> Septal-Occluder 10<span class="elsevierStyleHsp" style=""></span>mm&#44; coloc&#225;ndose bajo visi&#243;n fibrobroncosc&#243;pica al mismo tiempo&#44; sin complicaciones &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A y B&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">El paciente evolucion&#243; satisfactoriamente &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>C y D&#41;&#44; y al cabo de varios meses se pudo cerrar la toracostom&#237;a&#46;</p></span>"
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Article information
ISSN: 03002896
Original language: Spanish
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