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Bronchopleural Cutaneous Fistula

St. James's Hospital Trinity College Dublin, Ireland

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We report the imaging findings of a 60-year-old man who presented to our institution with dyspnea and sepsis. He had undergone neoadjuvant radiation therapy and a left lobectomy 3 years previously for a non-small-cell lung carcinoma. He had been well at follow-up in another institution but recently developed worsening dyspnea. CT of the thorax was performed (Fig. 1), which revealed a bronchopleural cutaneous fistula. This is a very rare late complication of lung resection for tumors and aspergillomas [1]. Patients complain of the unusual ability of being able to breathe with their upper airway occluded, and recurrent sepsis is of significant morbidity. Treatment includes endobronchial balloon occlusion and selective endobronchial intubation [1, 2]. This case highlights the vivid clinical picture that multiplanar reconstruction with MDCT can evoke.

View larger version (159K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Coronal reconstruction CT image of thorax shows bronchopleural cutaneous fistulas (F).

References

1. Snell GI, Holsworth L, Fowler S, et al. Occlusion of a broncho-cutaneous fistula with endobronchial one-way valves. Ann Thorac Surg 2005; 80:1930 –1932[Abstract/Free Full Text]
2. Jain R, Baijall SS, Phadke RV, Pandey CK, Saraswat VA. Endobronchial closure of a bronchopleural cutaneous fistula using angiography catheters. AJR 2000;175 :1646 –1648[Free Full Text]

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This Article Figures Only Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by O'Neill, A. Articles by Beddy, P. Search for Related Content PubMed PubMed Citation Articles by O'Neill, A. Articles by Beddy, P. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?