Respir Case Rep. 2023; 12(1): 11-14 | DOI: 10.5505/respircase.2023.37929

Mediastinal Pigtail Catheterization for Treatment of Pneumomediastinum in a COVID-19 Patient: A Case Report

Ashok P Arbat, Gauri Gadge, Sweta Chourasia, Parimal Deshpande, Swapnil Bakamwar
Department of Pulmonology, KRIMS Hospital, Nagpur, Maharashtra, India

Spontaneous pneumomediastinum (SPM) is a decisive complication reported to be associated with COVID-19. Here, we present a case of SPM in a COVID-19-positive patient that was not caused by any iatrogenic or known reasons. At the time of admission, the patient was COVID-positive and distressed. He was immediately subjected to hematological and radiological investigations (chest X-ray, HRCT), which confirmed pneumomediastinum. The patient was hypoxic and hypotensive even after receiving ionotropic support. Considering the patient's critical condition, a mediastinal pigtail catheterization was performed instead of a thoracotomy, and the catheter was in situ for nine days. Arterial blood gas was monitored during the hospital stay, and supplementary oxygen therapy was provided accordingly. The patient subsequently recovered and was discharged. Hence, SPM in this COVID patient was treated by pigtail catheterization, and major surgical interventions were avoided.

Keywords: spontaneous pneumomediastinum, mediastinal pigtail catheterization, COVID-19.

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COVID-19 Hastalarýnda Pnömomediasten Tedavisi Ýçin Mediastinal Pigtail Kateterizasyonu: Olgu Sunumu

Ashok P Arbat, Gauri Gadge, Sweta Chourasia, Parimal Deshpande, Swapnil Bakamwar
Ketki Týp Bilimleri Araþtýrma Enstitüsü, Pulmonoloji Bölümü, Nagpur, Hindistan

Spontan pnömomediastinum (SPM), COVID-19 ile iliþkili olduðu bildirilen belirgin bir komplikasyondur. Burada, COVID pozitif bir hastada herhangi bir iyatrojenik veya bilinen nedenden kaynaklanmayan bir SPM olgusu sunuyoruz. Baþvuru sýrasýnda hasta COVID-pozitifti ve stresli idi. Hemen hematolojik ve radyolojik incelemeler (Akciðer grafisi, YÇBT) alýndý ve pnömomediastinum saptandý. Hasta hipoksikti ve iyonotropik destek verilmesine raðmen hipotansifti. Hastanýn kritik durumu göz önünde bulundurularak torakotomi yerine mediastinal pigtail kateterizasyon uygulandý ve kateter 9 gün tutuldu. Hastanede kalýþ süresi boyunca arteriyel kan gazý takibi yapýldý ve buna göre ek oksijen tedavisi verildi. Daha sonra hastanýn durumu düzeldi ve stabil olarak taburcu edildi. Böylece, bu COVID hastasýndaki SPM, Pigtail kateterizasyonu ile tedavi edildi ve büyük cerrahi müdahalelerden kaçýnýldý.

Anahtar Kelimeler: spontan pnömomediasten, mediastinal pigtail kateterizasyonu, COVID-19.

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