Tuberc Respir Dis.  2007 Dec;63(6):507-510.

A Case of Bronchoscopic Treatment of a Bronchopleural Fistula Accompanied by Pneumonia

• Kim H

Abstract

A bronchopleural fistula (BPF) is traditionally treated by surgery, but currently various noninvasive forms of management, particularly the use of bronchoscopy, have been utilized. The substances and methods for noninvasive management of a BPF differ with individual clinicians. This case describes the use of flexible bronchoscopic treatment of a BPF complicating pneumoniausing embolization coils and intraluminally injected fibrin glue. If the BPF is small and is located on the peripheral bronchus, this minimal invasive maneuver could be recommended for the treatment of a BPF.

Keyword

Bronchopleural fistula; Bronchoscopy; Coil; Fibrin glue

MeSH Terms

Bronchi
Bronchoscopy
Fibrin Tissue Adhesive
Fistula*
Pneumonia*
Fibrin Tissue Adhesive

Figure

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  Figure 1 Initial chest X-ray finding of the patient: necrotizing pneumonia accompanying bronchopleural fistula in right upper lobe.

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  Figure 2 At three weeks after systemic antibiotics and closed thoracostomy for the treatment of bronchopleural fistula and necrotizing pneumonia, chest X-ray showed persistent dead space of right upper lobe. Also, minimal subcutaneous emphysema was noted in right axillary area.

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  Figure 3 Intraoperative X-ray finding during bronchoscopic coiling for treatment of bronchopleural fistula: there was no gastrograffin leakage into diseased bronchopleural tract after coiling and injection of glue. Before procedures, gastrograffin was used for localization of bronchopleural fistula tract, so small amount of leaked gastrograffin in both the dead space and chest tube is visible.

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  Figure 4 (A) Chest X-ray at discharge showed inserted colis into bronchopleural fistula and small amount of dead space and moderate pleural thickenings. (B) At 9 months postoperatively, chest x-ray revealed decreased pleural thickenings and well anchored coils in the bronchopleural fistula tract.

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