Suspected fibrin glue-induced acute eosinophilic pneumonia after pulmonary resection: A case report

THE USE OF FIBRIN GLUE IN THE TREATMENT OF BRONCHIAL STUMP FAILURE AFTER LOWER LOBECTOMY ON THE RIGHT (A CLINICAL CASE)

Despite the constantly improving technique of operations, the use of modern suture materials and stitching-cutting devices, the problem of the occurrence of the failure of the bronchial stump remains unresolved. Many methods have been proposed for the treatment of bronchial stump failure, ranging from endoscopic mucosal coagulation and the installation of various types of occluders and ending with repeated surgical interventions. There are a huge number of publications devoted to the use of fibrin glue in various fields of medicine, for example, in neurosurgery, maxillofacial surgery, orthopedics, dentistry and thoracic surgery, fibrin glue is successfully used, including in the development of bronchial stump failure. This article presents a clinical observation of the use of fibrin glue in the treatment of bronchial stump failure after lower lobectomy on the right.

Suspected fibrin glue-induced acute eosinophilic pneumonia after pulmonary resection: A case report

Air leakage is a common complication after pulmonary resection, and fibrin glue is used as a sealant to reduce postoperative air leakage. It is generally recognized that fibrin glue‐induced adverse events are rare. Herein, we report a rare case of suspected fibrin glue‐induced acute eosinophilic pneumonia (AEP). A 72‐year‐old man underwent right lower lobectomy and mediastinal lymph node dissection for right lower lung cancer. Fibrin glue was sprayed to cover the interlobar surface of the right upper and middle lobes. On postoperative day 10, computed tomography (CT) revealed ground‐glass shadows around the interlobar surface of the remaining lobes of the right lung. Although antibacterial drugs were administered for suspected bacterial pneumonia, fever spike, shortness of breath, and exacerbation of ground‐glass shadows were observed. Peripheral blood and bronchoalveolar lavage fluid showed increased eosinophil count, supporting the diagnosis of AEP. Pneumonia resolved after prednisolone administration. At one‐year follow‐up, CT showed no AEP recurrence. Drug‐induced pneumonia usually develops in the bilateral lung and rarely in the hemilateral lung. In this case, pneumonia was localized around the site covered with fibrin glue, suggesting fibrin glue‐induced AEP. Thus, the use of fibrin glue should be carefully considered during pulmonary resection.