A bronchopleural fistula (BPF) is a fistula between the pleural space and the lung. It can develop following pneumonectomy, lung ablation, post-traumatically, or with certain types of infection. It may also develop when large airways are in communication with the pleural space following a large pneumothorax or other loss of pleural negative pressure, especially during positive pressure mechanical ventilation. On imaging, the diagnosis is suspected indirectly on radiograph. Increased gas in the pneumonectomy operative bed, or new gas within a loculated effusion are highly suggestive of the diagnosis. Infectious causes include tuberculosis, Actinomyces israelii, Nocardia, and Blastomyces dermatitidis. Malignancy and trauma can also result in the abnormal communication.
References
- Shahrouki, Puja; Barclay, Jonathan; Khan, Sarah; Genshaft, Scott; Abtin, Fereidoun; McGraw, Charles; Baek, Donny; Nickel, Barbara; Suh, Robert (February 2021). "Treatment of Post-Ablation Bronchopleural Fistula Using Percutaneous Synthetic Hydrogel Surgical Sealant: Initial Experience of Safety and Efficacy". CardioVascular and Interventional Radiology. 44 (2): 325–332. doi:10.1007/s00270-020-02691-3. ISSN 1432-086X. PMID 33174141. S2CID 226294934.
- Varoli F (1998) Endoscopic treatment of bronchopleural fistulas. Annals of Thoracic Surgery 65, 807-9
- Kempainen, RR; Pierson, DJ (December 2001). "Persistent air leaks in patients receiving mechanical ventilation". Seminars in Respiratory and Critical Care Medicine. 22 (6): 675–84. doi:10.1055/s-2001-18804. PMID 16088712. S2CID 36172602.
- Lois, M; Noppen, M (December 2005). "Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management". Chest. 128 (6): 3955–65. doi:10.1378/chest.128.6.3955. PMID 16354867.
External links
- BRONCHOPLEURAL FISTULA, Intensive Care Unit, Prince of Wales Hospital, Chinese University of Hong Kong