. 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.


COVID-19 Hastalarında Pnömomediasten Tedavisi İçin Mediastinal Pigtail Kateterizasyonu: Olgu Sunumu

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

Spontan pnömomediastinum (SPM), COVID-19 ile ilişkili olduğu bildirilen belirgin bir komplikasyondur. Burada, COVID pozitif bir hastada herhangi bir iyatrojenik veya bilinen nedenden kaynaklanmayan bir SPM olgusu sunuyoruz. Başvuru sırasında hasta COVID-pozitifti ve stresli idi. Hemen hematolojik ve radyolojik incelemeler (Akciğer grafisi, YÇBT) alındı ve pnömomediastinum saptandı. Hasta hipoksikti ve iyonotropik destek verilmesine rağmen hipotansifti. Hastanın kritik durumu göz önünde bulundurularak torakotomi yerine mediastinal pigtail kateterizasyon uygulandı ve kateter 9 gün tutuldu. Hastanede kalış süresi boyunca arteriyel kan gazı takibi yapıldı ve buna göre ek oksijen tedavisi verildi. Daha sonra hastanın durumu düzeldi ve stabil olarak taburcu edildi. Böylece, bu COVID hastasındaki SPM, Pigtail kateterizasyonu ile tedavi edildi ve büyük cerrahi müdahalelerden kaçınıldı.

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


Ashok P Arbat, Gauri Gadge, Sweta Chourasia, Parimal Deshpande, Swapnil Bakamwar. Mediastinal Pigtail Catheterization for Treatment of Pneumomediastinum in a COVID-19 Patient: A Case Report. . 2023; 12(1): 11-14

Corresponding Author: Ashok P Arbat, India


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