Page 52 - ECBIP 2021_Program
P. 52

6th European Congress ECBIP 15 - 17
  Book of Abstracts
for Bronchology and
Interventional Pulmonology ATHENS - GREECE 2021
OCTOBER
 MODERATED e-POSTER SESSION 03:
EBUS Bronchoscopy
        PNEUMOMEDIASTINUM AND TRACHEOMEDIASTINAL FISTULA AS A COMPLICATION OF EBUS-TBNA
Vânia Fernandes1, Michele de Santis2, Paulo Matos2, Lourdes Barradas2
1 Pulmonology Unit, Centro Hospitalar E Universitário De Coimbra, Coimbra, Portugal
2 Pulmonology Unit, Instituto Português de Oncologia Francisco Gentil de Coimbra, Coimbra, Portugal
     PP17
    Introduction: Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) is an essential diagnostic tool for a variety of thoracic diseases presenting with enlarged lymph nodes, particularly in diagnosis and staging of lung and mediastinal tumours.
It’s a safe procedure when performed by experienced respiratory endoscopists, with its most frequent complications being haemorrhage, infection (particularly mediastinitis) and pneumothorax. Pneumomediastinum is a very rare complication, with the majority of cases reported in individuals with interstitial lung disease.
Case report: A 69-year-old male patient underwent EBUS-TBNA for lung lepidic adenocarcinoma staging. Immediately after needle sampling of 4R station, endobronchial signs of tracheal fistula were perceived (a patent millimetric orifice, with air going in and out of it).The procedure was completed in another suitable station and promptly ended,and the patient remained closely watched.Twenty-four hours later,dysphonia and subcutaneous emphysema of neck and left-side face developed (Fig 1). Chest CT revealed extensive pneumomediastinum, and cervical subcutaneous emphysema. Orbital compartment syndrome was excluded by cranial and orbital CT. Patient was placed under supplemental oxygen with close surveillance; progressive absorption was achieved and two days later he was discharged from hospital.
Obtained lymph nodes samples were diagnostic for 4R station lymph node metastasis of adenocarcinoma. A bronchoscopy performed 4 weeks later confirmed a closed fistula at 4R lymph node location (Fig 2).
Conclusion: This case reports a very rare complication of EBUS-TBNA, and alerts for endoscopic signs that can predict it, and that should motivate close surveillance.
Figure 1: Left-side swelling of patient’s face secondary to extensive subcutaneous emphysema.
Figure 2: Bronchoscopy performed 4 weeks after discharge confirming a closed fistula at anterior / right side wall of trachea (4R lymph node location).
  52 6th European Congress for Bronchology and Interventional Pulmonology
  














































































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