{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:10:19Z","timestamp":1756293019102,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,6,28]]},"abstract":"<jats:p>A 59-year-old man with bilateral apical emphysema underwent a double lung transplant for end-stagechronic obstructive pulmonary disease leaving remnant right apical native tissue due to pleural adhesions. Initial postoperative course was uneventful until the chest drains were removed. This revealed a small pneumomediastinum, which progressively increased in size causing gross surgical emphysema. Re-insertion of the chest drain stabilised the patient so that the cause could be identified and corrected. Two bronchoscopies excluded anastomotic dehiscence as a cause. Therefore the subcostal wound was refashioned under video-assisted thoracoscopic surgery in case there was a defect. Unfortunately this also failed to halt the air leak; therefore another cause was sought. A multidisciplinary team meeting review of the radiology revealed that the patient's native bullous tissue was still inflated. Subsequent bronchoscopy revealed a native bronchial communication, due to variant anatomy, proximal to the surgical anastomosis. This was subsequently occluded using a bronchial valve allowing the patient to make a swift recovery.<\/jats:p>","DOI":"10.1136\/bcr-2017-220176","type":"journal-article","created":{"date-parts":[[2017,7,27]],"date-time":"2017-07-27T05:54:01Z","timestamp":1501134841000},"page":"bcr-2017-220176","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent air leak after pulmonary transplantation"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7651-5682","authenticated-orcid":false,"given":"Laurence","family":"Pearmain","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK"},{"name":"Piper Hanley Group, University of Manchester Institute of Human Development, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Krysiak","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Blaikley","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK"},{"name":"Division of infection, Immunity and Respiratory medicine, University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Alaloul","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,7,27]]},"reference":[{"key":"2025082703475386000_2017.jul27_1.bcr-2017-220176.1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200808-094GO"},{"key":"2025082703475386000_2017.jul27_1.bcr-2017-220176.2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-1171"},{"key":"2025082703475386000_2017.jul27_1.bcr-2017-220176.3","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.21.1.g01ja06105"},{"key":"2025082703475386000_2017.jul27_1.bcr-2017-220176.4","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.080280"},{"key":"2025082703475386000_2017.jul27_1.bcr-2017-220176.5","doi-asserted-by":"crossref","first-page":"432","DOI":"10.12659\/MSM.891320","article-title":"Endobronchial valves in treatment of persistent air leaks: a systematic review of clinical evidence","volume":"21","author":"Gkegkes","year":"2015","journal-title":"Med Sci Monit"},{"key":"2025082703475386000_2017.jul27_1.bcr-2017-220176.6","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2005.044537"},{"key":"2025082703475386000_2017.jul27_1.bcr-2017-220176.7","first-page":"320","article-title":"Efficacy and safety of endobronchial valves for advanced emphysema: a meta analysis","volume":"7","author":"Liu","year":"2015","journal-title":"J Thorac Dis"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-220176","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:48:05Z","timestamp":1756291685000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-220176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,27]]},"references-count":7,"alternative-id":["10.1136\/bcr-2017-220176"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-220176","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,7,27]]}}}