A Case of Acute Respiratory Failure due to Colonobronchial Fistula Treated by Endobronchial Occlusion Using Endobronchial Watanabe Spigot (EWS)

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  • EWSを用いた気管支充填で救命した急性呼吸不全を呈した結腸気管支瘻の1例
  • EWS オ モチイタ キカンシ ジュウテン デ キュウメイ シタ キュウセイ コキュウ フゼン オ テイシタ ケッチョウ キカンシロウ ノ 1レイ

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<p>Colonobronchial fistula (CBF) can induce severe pneumonia due to inflow of feces via a fistula created between the colon and the bronchus. We report a case of which pneumonia caused by CBF was treated by endobronchial occlusion using Endobronchial Watanabe Spigot (EWS).</p><p>The patient was a 75-year-old man who had been on the treatment with percutaneous drainage and antibiotic therapy for left subdiaphragmatic abscess caused by descending colon perforation. During the treatment, the abscess penetrated the diaphragm, forming a pulmonary abscess in the basal segment of the left lung. In addition, the pulmonary abscess ruptured into the bronchi, causing severe pneumonia due to fecal inflow. He developed acute respiratory failure and septic shock. In order to save his life, we performed the resection of the perforated colon, colostomy, and simultaneously EWS occlusion to the responsible bronchi. After the endobronchial occlusion, the fecal inflow disappeared, respiratory condition became stable during surgery and the pneumonia was improved. He was discharged home about 2.5 months after the operation. Endobronchial occlusion using EWS is useful for colonobronchial fistula.</p>

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