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Case Reports: Unusual presentation of more common disease/injury
Pulmonary Artery Bleed from an Eloesser flap
  1. Chandni Patel1,
  2. Graham Reed Ellington1 and
  3. Dale Okorodudu1,2
  1. 1Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
  2. 2Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Dallas VA Medical Center, Dallas, Texas, USA
  1. Correspondence to Dr Chandni Patel; Chandni.patel{at}utsouthwestern.edu

Abstract

An open thoracic window involves the creation of a semi-permanent pleural-cutaneous connection to treat chronic organising empyemas, bronchopleural fistulas and postpneumonectomy empyemas in patients too ill for video-assisted thoracic surgery decortication. An Eloesser flap is a type of open thoracic window. Antibiotics have made the use of Eloesser flaps and other open thoracic windows for treatment of empyemas rare. Consequently, not much is known about the chronic complications of open thoracic windows. However, structural compromise of vasculature secondary to chronic inflammation has been previously proposed as a mechanism for spontaneous pulmonary haematomas related to anatomic deformation. We depict a case of spontaneous pulmonary arterial bleed presenting as chest wall haemorrhage due to a chronic modified Eloesser flap.

  • Adult intensive care
  • Respiratory medicine
  • Cardiothoracic surgery
  • Pleural infection

https://doi.org/10.1136/bcr-2021-245741

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    Footnotes

    • Contributors CP participated in reviewing current literature, acquiring information, obtaining consent and authoring the manuscript. GRE contributed in reviewing current literature, planning the report, acquiring data and images, and authoring the manuscript. DO lead the project, interpreted the case presentation as well as authored, edited and approved the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.