Major complaints of this fully conscious patient at the time of presentation ∼2 hours after ingestion of colchicine were nausea and impaired vision. Apart from a colchicine serum concentration of 16.2 ng/mL, no abnormalities were seen in the physical examination and blood tests. Gastrointestinal decontamination by activated charcoal, repeated administrations of sodium sulfate (Glauber salt) and substitution of volume and electrolytes led to complete recovery.
Background: Persistent air leak (PAL) is a severe complication of secondary
spontaneous pneumothorax (SSP). Surgical interventions are usually successful
when medical treatment fails, but can be associated with significant
complications and loss of potentially recoverable lung parenchyma. Methods:
Retrospective analysis of efficacy and safety of interventional bronchus
occlusions (IBO) using Amplatzer devices (ADs) in children with PAL secondary to
SSP. Results: Six patients (four males, 4–15 years of age) underwent IBO
using ADs as treatment for PAL. Necrotizing pneumonia (NP) was the most common
cause (n=4) of PAL. Three patients were previously healthy and three
suffered from chronic lung disease. All patients required at least two chest
tubes prior to the intervention for a duration of 15–43 days and all
required oxygen or higher level of ventilatory support. In three cases, previous
surgical interventions had been performed without success. All children improved
after endobronchial intervention and we observed no associated complications.
All chest tubes were removed within 5–25 days post IBO. In patients with
PAL related to NP (n=4), occluders were removed bronchoscopically
without re-occurrence of pneumothorax after a mean of 70 days (IQR:
46.5–94). Conclusion: IBO using ADs is a safe and valuable treatment
option in children with PAL independent of disease severity and underlying
cause. A major advantage of this procedure is its less invasiveness compared to
surgery and the parenchyma- preserving approach.
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