Publication:

Post traumatic persistent broncho-pleural fistula managed with autologous blood patch pleurodesis: a rare case report

Persistent air leak (PAL) and bronchopleural fistula (BPF) following penetrating thoracic trauma are uncommon and pose significant therapeutic challenges. Surgical repair and endoscopic interventions may not always be feasible, particularly in peripheral fistulas or in hemodynamically fragile patients. We report a rare case of post-traumatic persistent BPF following a close-range firearm injury to the chest in a 26-year-old male. Despite initial stabilization and intercostal drainage, the patient developed recurrent pneumothorax with massive air leak after chest tube removal. Imaging confirmed a BPF. Autologous blood patch pleurodesis (ABPP) was performed via the intercostal drain using 100 mL of autologous blood. A repeat instillation was required after 24 hours due to PAL, following which complete resolution was achieved. The lung remained fully expanded, and the chest tube was successfully removed without complications. This case highlights ABPP as a simple, safe, cost-effective, and minimally invasive option for managing refractory post-traumatic PAL when conventional measures fail.