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ISSN 1405-0625 (Print)

2022, Number 1

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Cir Plast 2022; 32 (1)

Reconstruction of pleural window with latissimus dorsi flap and posterior improvement of the restrictive pattern

Ríos LLRL, Mendoza-Ramírez JB, Méndez-Chávez JC, Ugalde-Vitelly JA, Torres-Piña R

Language: Spanish
References: 27
Page: 43-50
PDF size: 411.93 Kb.


ABSTRACT

Tuberculosis is an infection caused by Mycobacterium tuberculosis complex. There are two clinical variants: pulmonary and extrapulmonary tuberculosis. Pleural tuberculosis is 20% of the cases of extrapulmonary tuberculosis, which is a cause of pleural effusion in endemic areas and immunocompromised patients. A pleural effusion with compromised from parenchymal can cause an alveolo-pleural or bronchopleural fistula with spontaneous pneumothorax and empyema. Besides the medical treatment, drainage of the pleural effusion must be performed through a thoracostomy tube. The Eloesser technique thoracostomy window is a surgical treatment option for patients with tuberculosis and pleural space infection associated with bronchopleural fistulas. It aims at permanent drainage of the infected pleural space, it is a viable option when a probe thoracotomy is inadequate, the patient is not a candidate for decortication, or if the lung does not completely fill the chest cavity after decortication. The integrity and stability of the chest wall ensures the protection of the internal organs and adequate respiratory function; for this reason, the reconstruction of the defects caused by previous procedures is important. We present the case of a patient treated at the Hospital General de Mexico "Dr. Eduardo Liceaga" with pulmonary and pleural tuberculosis complicated with bronchopleural fistula and persistent pleural effusion that required treatment of the pulmonary window with the Eloesser technique by the pneumology department and reconstruction of the defect with a latissimus dorsi flap with its subsequent evaluation after four months by spirometry to show an improvement of the restrictive pattern.


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