A Rare Treatment Modality and its Unusual Complication: Pneumomediastinum and Subcutaneous Emphysema Following Argon Plasma Coagulation.
Argon plasma coagulation is an effective non-contact electrosurgery tool and the use
of APC in interventional pulmonology is relatively recent. Successful endobronchial APC
has been described in debulking malignant airway tumors, controlling hemoptysis, removing
granulation tissue from stents or anastomoses, and treating various benign airway disorders.
Main complications related to APC are pneumomediastinum, subcutaneous emphysema,
pneumothorax, airway fire, and burned bronchoscope. This report
describes a case of very rare complication of APC
following an attempt to relief airway obstruction caused by a lung malignancy.
Heat energy produced by this process causes the tissue coagulation or
hemostasis. The heat evaporates intracellular and extracellular water and denatures proteins,
producing the coagulative and destructive effects on tissue.
This technique was first used with
gastrointestinal endoscopy using a flexible probe in the early 1990’s and was used mainly
as a modality for hemostasis during polypectomy.
Subsequently, it has also been used in otolaryngology and dermatology. More
recently, APC has been successfully used during bronchoscopic procedures to
debulk malignant airway tumours, control hemoptysis,
remove granulation tissue from
stents or anastomoses, and treat a variety of other benign disorders.
Pneumomediastinum, subcutaneous emphysema, pneumothorax, airway fire, and
burned bronchoscope are complications of APC. However, these
complications are reported in less than 1% of the all cases.
This report describes a case of very rare
complication of APC following an attempt to relief airway
obstruction caused by a malignant lung tumour.
Pulm Res Respir Med Open J. 2016; 3(1): 19-22. doi: 10.17140/PRRMOJ-3-126