25-year-old man overcomes Bronchial perforation caused by Covid19

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A sus 25 años, Diana Bustamante nunca pensó que estaría al borde de la muerte por covid-19, luego de estar internada en el hospital San Juan de Dios por más de dos meses, comparte su historia.

Durante su hospitalización su situación fue crítica, el coronavirus le produjo neumonía (infección en los pulmones) que le trajo graves consecuencias como una perforación bronquial que requirió de la experiencia, pericia y conocimiento de un equipo de especialistas del San Juan de Dios. Esta joven madre de una niña de seis años, vecina del cantón de Mora, cuenta que en un inicio le dolía muchísimo la cabeza y el cuerpo, tuvo fiebre y después no podía respirar y tenía mucha tos, “me dolía mucho el pecho y el pulmón” por lo cual del área de Salud Mora-Palmichal la trasladaron al San Juan de Dios de emergencia.

Diana’s condition was serious, in order to improve her condition it was necessary to perform surgery to clean the pleural space (cavity between the lungs and under the chest wall, which is usually empty) that was filled with pus, since this did not allow the antibiotics to work correctly.

The thoracic surgeon, Ricardo Alfaro Pacheco indicated that Diana was very ill, he mentioned that even the surgery meant a very great risk, the procedure lasted 45 minutes, two chest surgeons and the operating room team that is made up of nurses and a anesthesiologist doctor.

“The surgery was to clean the pleural space that was filled with pus, and place a drain so that all the infection would come out. When we were cleaning, we found the bronchial perforation (similar to a leak) in the left lung, we had to act as soon as possible, and seal it provisionally. In the postoperative period, her evolution was satisfactory, every day she improved. Seeing her so well now fills me with great joy ”said the surgeon.

Although the surgery was successful, Diana faced another surgical procedure. The pulmonologists placed plugs in the bronchi called “spigots” this caused the leak to close completely.

It is the first time in the country that this technique is carried out in such a complex case, a product of COVID-19. Juan Antonio Botero, interventional pulmonologist explained that Diana being a young woman and in good condition (before the covid) she was a candidate for the procedure, the surgery was performed to save her life. “Her lung was quite damaged, that area was similar to” a tire when she is punctured “, and the surgeons at that time could not close the leak because her lung was very inflamed.

We close the bronchial leak using devices called “spigots”, they are like a cork that we place in the bronchus that is feeding the leak in order to close it. If the leak cannot be corrected, the mortality is greater than 90% ”, explained the specialist. After placing the devices, the leak disappeared.

This procedure was possible because Diana was admitted to the Bronchopulmonary Unit, which the San Juan de Dios inaugurated in February 2020, where she integrated the bronchoscopy room (to perform interventional pulmonology procedures) and the hospitalization area. For both doctors, this was a very coordinated work with a very large team of people from radiology, laboratory, nursing, anesthesia, among others, they also recognized that both the hospital and the CCSS have all the technology and supplies to be able to work, and save lifes.

Diana visits the hospital twice a week for post-covid rehabilitation for foot drop syndrome due to prolonged bedridden. Allan Araya Sánchez, physical therapist explained that at this moment there are 35 patients under follow-up with sequelae due to hospitalization due to COVID, they receive virtual home care and outpatient consultation.

A physiatrist and physiotherapists work in the physical rehabilitation of covid patients since they are hospitalized. Diana does not hide her happiness every time she meets one of the people who cared for her, she is very grateful for all the effort, full of dreams, goals and with great strength, and they are very satisfied to see her recovered. A heroic measure in medicine is when a decision is made to do something for the patient, knowing that their chances of survival are slim despite the effort.

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