Bronchopleural fistula

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.[1][2] 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.[3] 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.[4]

References

  1. ^ 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.
  2. ^ Varoli F (1998) Endoscopic treatment of bronchopleural fistulas. Annals of Thoracic Surgery 65, 807-9
  3. ^ 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.
  4. ^ 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.