Repair of a traumatic subarachnoid-pleural fistula with the percutaneous injection of fibrin glue in a 2-year-old

Jason K. Chu, Brandon A. Miller, Michael P. Bazylewicz, John F. Holbrook, Joshua J. Chern

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Subarachnoid-pleural fistulas (SPFs) are rare clinical entities that occur after severe thoracic trauma or iatrogenic injury during anterolateral approaches to the spine. Treatment of these fistulas often entails open repair of the dural defect. The authors present the case of an SPF in a 2-year-old female after a penetrating injury to the chest. The diagnosis of an SPF was suspected given the high chest tube output and was confirmed with a positive b2-transferrin test of the chest tube fluid, as well as visualization of dural defects on MRI. The dural defects were successfully repaired with CT-guided percutaneous epidural injection of fibrin glue alone. This case represents the youngest pediatric patient with a traumatic SPF to be treated percutaneously. This technique can be safely used in pediatric patients, offers several advantages over open surgical repair, and could be considered as an alternative first-line therapy for the obliteration of SPFs.

Original languageEnglish
Pages (from-to)13-18
Number of pages6
JournalJournal of Neurosurgery: Pediatrics
Volume17
Issue number1
DOIs
StatePublished - Jan 2016

Bibliographical note

Publisher Copyright:
© 2016 AANS.

Keywords

  • Fibrin glue
  • Gunshot wound
  • Pediatrics
  • Spinal penetrating injury
  • Spine
  • Subarachnoid-pleural fistula
  • Technique
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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