Simultaneous Bilateral Endobronchial Valve Insertion for Management of Persistent Air Leaks Secondary to Necrotising Pneumonia.

Pneumothorax is an abnormal communication between the tracheobronchial tree and the pleural space either as a result of a broncho-pleural fistula or an alveolo-pleural fistula. When the air leak from these fistulae persists beyond 5 days it is defined as a persistent air leak (PAL). Whilst surgical repair remains the standard of care, endobronchial valves (EBVs), established for bronchoscopic lung volume reduction (BLVR), are emerging as a minimally invasive alternative. Current data supporting the use of EBVs in PAL are limited to case reports and small retrospective case series. This report details a rare case of bilateral PAL secondary to necrotising pneumonia in a critical ill patient, successfully managed with simultaneous bilateral EBV placement, highlighting the feasibility and clinical efficacy of this approach.