부산대학교 도서관

A 44-year-old man with amyotrophic lateral sclerosis who had required mechanical ventilation because of his bulbar paralysis presented with dyspnea. A chest roentgenogram was obtained, and he was diagnosed with left tension pneumothorax. A chest drainage tube was inserted; however, the pneumothorax did not improve and there was an excessive and continuous air leak. Twelve days after onset, he underwent endobronchial occlusion with an Endobronchial Watanabe Spigot (EWS®), and the air leak significantly decreased. Thirteen days after onset, pleurodesis with minocycline and 50% glucose solution was performed. Following the pleurodesis, the air leak was completely sealed. The chest drainage tube was removed 15 days after onset. At four months post-treatment, there was no recurrence of the pneumothorax. Combined therapy with endobronchial occlusion and pleurodesis might be a useful treatment modality for intractable pneumothorax.