暂无摘要。

Pulmonary complications, such as airway leak syndrome, are common in preterm neonates; however, bronchial rupture is a rarely seen phenomenon.
In this case, we present a preterm newborn who developed pneumomediastinum and pneumothorax. The pneumothorax persisted, despite placement of a thorax tube, requiring a thoracotomy to detect and treat the bronchial rupture.
Physicians should have a high suspicion of bronchial rupture in patients with persistent air leak syndrome, even after thorax tube placement and continuous negative pressure implementation.

Although pneumothorax is a well-known complication of COVID-19 pneumonia especially in patients requiring mechanical ventilation, bronchopleural fistula causing persistent pneumothorax in sole COVID-19 pneumonia is extremely rare. In this case, we illustrate that bronchopleural fistula can be found in COVID-19 pneumonia, even with no risk factors nor mechanical ventilation administration.

Pneumothorax is the most common type of air leak. Although the majority of pneumothoraces resolves spontaneously, some continue several days after the lung injury. Autologous blood patch pleurodesis is the most commonly used technique in the treatment of persistent pneumothorax. The use of an autologous blood patch in persistent pneumothorax in neonates has not been reported before. We report the first case of newborn persistent pneumothorax successfully treated with an autologous blood patch. The patient was a newborn aged 2 days. He was admitted to the neonatal intensive care unit due to subcostal-intercostal retractions after birth. Chest X-ray was performed and pneumothorax was detected on the right side. Persistence of the air leak led to treatment with an autologous blood patch on day 17 of pneumothorax development. Pleurodesis was repeated on days 3 and 6 of the first autologous blood patch, respectively. Air leak sealed within 2 days after the third autologous blood patch. In our opinion, this procedure is safe and effective when performed with the correct technique, and can also be used safely in newborns.
Pnömotoraks en sık görülen hava kaçağı tipidir. Her ne kadar pnömotoraksların çoğu kendiliğinden düzelse de, bazıları akciğer hasarından birkaç gün sonra da devam eder. Otolog kan yaması ile yapılan plörodezis persistan pnömotoraks tedavisinde en sık kullanılan tekniktir. Yenidoğanlarda persistan pnömotoraksta otolog kan yamasının kullanımı daha önce bildirilmemiştir. Bu çalışmada otolog kan yama tekniği ile başarılı bir şekilde tedavi edilen ilk yenidoğan persistan pnömotoraks olgusu sunulmuştur. İki günlük yenidoğan olgumuz doğum sonrası subkostal-interkostal çekilmeler nedeniyle Yenidoğan Yoğun Bakım Birimi’ne yatırıldı ve çekilen akciğer grafisinde sağ tarafta pnömotoraks saptandı. Hava kaçağının devam etmesi nedeni ile, hastaya, pnömotoraks gelişiminin 17. gününde otolog kan yaması ile plörodezis yapıldı. Plörodezis ilk uygulamadan sonraki 3. ve 6. günlerde iki kez daha tekrar edildi. Üçüncü otolog kan yamasından sonra iki gün içinde hava kaçağı tamamen geriledi. Fikrimizce bu teknik doğru bir şekilde uygulandığında güvenli ve etkili bir iyileşme sağlamaktadır ve yenidoğanlarda da güvenle kullanılabilir.

Evaluation for pneumothorax is an important indication for obtaining chest radiographs in patients who have had trauma, recent cardiothoracic surgery or are on ventilator support. By definition, a persistent pneumothorax constitutes ongoing bubbling of air from an in situ chest drain, 48 h after its insertion. Persistent pneumothorax remains a diagnostic dilemma and identification of potentially treatable aetiologies is important. These may be chest tube related (kinks or malposition), lung parenchymal disease, bronchopleural fistula, or rarely, oesophageal-pleural fistula. Although radiographs remain the mainstay for diagnosis and follow up of pneumothorax, computed tomography (CT) is increasingly being used for problem solving. Aetiology of persistent air leak determines the optimal treatment. For some, a simple repositioning of the chest tube/drain may suffice; others may require surgery. In this pictorial review, we will briefly describe the physiology of pneumothorax, discuss imaging features of identifiable causes for persistent pneumothorax and provide a brief overview of treatment options. Specific aetiology of a persistent air leak may often not be immediately discernible, and will need to be carefully sought. Accurate interpretation of imaging studies can expedite diagnosis and facilitate prompt treatment. Key points • Persistent pneumothorax is defined as a leak persisting for more than 2 days.• Radiographs can identify chest-tube-related causes of pneumothorax.• CT is the most useful test to identify other causes.• Penetrating thoracic injury can cause fistulous communication resulting in a persistent pneumothorax.• Discontinuity of visceral pleura identified by CT may indicate a bronchopleural fistula.