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Surgery
Postpneumonectomy space infection eight years after mediastinal repositioning procedure
  1. Edward Staniforth1,
  2. Rhona Taberham2,
  3. Lucy Cogswell3 and
  4. Elizabeth Belcher2
  1. 1Medical School, University of Oxford, Oxford, UK
  2. 2Department of Thoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  3. 3Department of Plastic & Reconstructive Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  1. Correspondence to Miss Elizabeth Belcher; elizabeth.belcher{at}ouh.nhs.uk

Abstract

Postpneumonectomy syndrome is a rare complication following pneumonectomy. Repositioning of the mediastinum via insertion of prosthetic implants into the postpneumonectomy space can provide symptomatic relief. We present a case of a man in his early 70s presenting with empyema necessitans 8 years after the implantation of silicon-saline prostheses for the management of postpneumonectomy syndrome. Excision of the chest wall sinus, re-do right thoracotomy and removal of the infected silicon-saline prostheses and postprocedural intrapleural irrigation led to resolution. There was no evidence of mediastinitis. At the 1-year follow-up, the patient remained well, with a centralised mediastinum without further evidence of infection of the postpneumonectomy space. This is to our knowledge the first reported case of chronic infection of a repositioned mediastinum in the context of postpneumonectomy syndrome.

  • Empyema
  • Lung cancer (oncology)
  • Pleural infection
  • Cardiothoracic surgery
  • Plastic and reconstructive surgery

https://doi.org/10.1136/bcr-2024-263481

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    Footnotes

    • Contributors ES: conceptualisation, methodology, writing - original draft and writing - review and editing. RT: writing - review and editing. LC: writing - review and editing. EB: conceptualisation, methodology, writing - review and editing, supervision and project administration. EB is responsible for the overall content as guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.