BMJ Case Reports 2012; doi:10.1136/bcr.02.2012.5881
  • Novel treatment (new drug/intervention; established drug/procedure in new situation)

The use of a portable digital thoracic suction Thopaz drainage system for the management of a persistent spontaneous secondary pneumothorax in a patient with underlying interstitial lung disease

  1. Nik Hirani2
  1. 1Department of Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr William Stephen Arthur Jenkins, williamjenkins{at}

We present the case of a 68-year-old woman who presented in extremis with a secondary pneumothorax with a past history of severe idiopathic pulmonary fibrosis. Following insertion of a 32F intercostal drain, she developed a persistent broncho-pleural fistula and became dependent on negative-pressure wall-mounted suction to prevent respiratory compromise. She declined definitive surgical intervention and was therefore managed conservatively. After adhering to the wall-mounted suction method for 49 days, we obtained for use a portable digital thoracic drainage system previously used only in the cardiothoracic postoperative patient. This electronically delivered, negative-pressure drainage system induced radiographic improvement within 24 h, and allowed the patient to mobilise for the first time since admission. The patient was discharged home with the Thopaz drain in situ 8 weeks after placing it, and the drain was removed successfully with a resolved pneumothorax 20 weeks  after her initial presentation.


  • Competing interests None.

  • Patient consent Obtained.

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