Complex treatment of a functionally inoperable patient with spontaneous pneumothorax on the background of COVID-19

The article describes a clinical case in a 68-year-old patient with spontaneous pneumothorax that occurred against the background of COVID-19. The patient was admitted to the thoracic department from the ICU with signs of pneumothorax after suffering from SARS-CoV-2 pneumonia. After the installation of two pleural drains with active aspiration, there was no positive effect in the form of lung expansion. The flow of air through the drainage continued in dynamics with the appearance of a liquid turbid component, subcutaneous emphysema persisted. The severe comorbid background did not allow it to be used as an endosurgical, much less an "open intervention” due to the high risk of death. In order to block the bronchopleural anastomosis, fibrobronchoscopy was performed with the installation of a reverse endobronchial valve in the lumen of the draining bronchus. For valvular bronchoblocation (CBB), we used the original domestic device of the A.V. Levin system ("Medlang”). In the postoperative period, the disappearance of air discharge, relief of subcutaneous emphysema was noted. During the X-ray examination, the lung was straightened. The patient was discharged from the department to the rehabilitation department. During the examination, there were no signs of recurrent pneumothorax in the dynamics.