I am a practicing physician in rural India.A 18 year old female with chronic resp. tract infection,(possibly with some autoimmune disease)
suddenly became severely breathless with Spo2 20% A needdle was inserted in lower axillary area, Air was drained and improved dramatically.Xray showed bulla and not Pneumothorax, and hence Tube was not put in.In next 6 hours same thing happened twice and ultimately Tube was inserted as last resort.Patient is now well settled.Fluid column has stopped moving and repeat xray shows complete collapse of Bulla, but now What? Is she bound to get Bronco pulm fistula?When to remove Tube?
(At present we are trying to shift her to higher center but there are are practical difficulties )