Nil Intervention is at Times the Best Intervention

Abstract

A sudden drop of air-fluid level in the pneumonectomy space in the absence of a bronchopleural fistula and pleural infection is termed benign emptying of the post pneumonectomy space (BEPS). We herein report a case of benign emptying of pneumonectomy space, briefly review the literature and enumerate possible mechanisms for the same. It is an extremely rare entity and follows a benign course. Patients with BEPS are clinically stable, afebrile with no fluid expectoration, and have a normal white blood cell count. Bronchoscopy reveals an intact bronchial stump and pleural fluid cultures are often sterile. Close monitoring and early detection of a bronchopleural fistula is the management. Clinicians should keep BEPS among the differential diagnosis in case of a drop in the air-fluid level of the post pneumonectomy space. Awareness of this entity is crucial as it helps prevent unnecessary and morbid surgical interventions.
 Keywords: Pneumonectomy; BEPS; Bronchopleural Fistula; India.