Persistent air leak treated by autologous blood patch pleurodesis: the role of CT-guided small-bore chest tube insertion.

Autologous blood patch pleurodesis (ABPP) offers an alternative to surgery when conservative management is ineffective for treating a persistent air leak (PAL). In the traditional technique, autologous venous blood is introduced into the affected pleural cavity via a blindly inserted large-bore surgical chest tube. Herein, we present a case of an 18 year old male with a PAL following video assisted thorascopic bleb resection and talc pleurodesis who underwent successful ABPP using a small-bore pigtail catheter placed under computed tomography (CT) guidance. As compared to the traditional technique, this approach may potentially offer several advantages, such as more precise chest tube placement over the air leak site and reduced pain with chest tube insertion. Although image-guided chest tube insertion is a commonly performed procedure, its use for the specific indication in this patient's case has not been described in the literature, to the best of our knowledge.