PMC8602042_01
A) Computed tomography of the chest demonstrating a large left pneumothorax with rightward mediastinal shift and a small left pleural effusion. B) Axial computed tomography of the chest demonstrating a bronchopleural fistula (BPF) in the left lower lobe (red arrow). A chest tube remains in place with a small residual pneumothorax. C) Chest x-ray following endobronchial valve placement on hospital day 8. D) Computed tomography of the chest obtained three months following hospital discharge and six weeks following endobronchial valve removal, demonstrating cystic bronchiectasis in the left lung with significantly improved bronchial impaction of the left lower lobe and BPF resolution (red arrow). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Chest x-ray revealed a large pneumothorax with rightward mediastinal shift, and he was admitted to the hospital (Fig. 1A). A repeat computed tomography of the chest revealed evidence of a substantial pleural defect representative of the site of a BPF in the left lower lobe (Fig. 1B). A small pneumothorax remained on chest imaging post-bronchoscopy (Fig. 1C). He had complete resolution of his left pneumothorax (Fig. 1D).
Bronchoscopy images from endobronchial valve removal one month after chest tube removal. A) The yellow arrow identifies the endobronchial valve in place in the superior segment of the left lower lobe. B) The yellow arrow points to the superior segment of the left lower lobe after removal of the endobronchial valve. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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One month after chest tube removal, his EBV was removed (Fig. 2).