Article Type : Case Report
Authors : Rana L, Nayyar N and Kumar N
Keywords : Bronchopleural fistula; CT scan
Bronchopleural fistula
is a fistulous communication between pleural space and bronchial tree, and it a
part of process rather than a disease entity. The CT scan is not only important
in localisation of the broncho pleural fistula but also in finding out the
probable etiological factor.
Bronchopleural fistula is fistulous communication
between pleural cavity and bronchial tree secondary to some disease process or
injury. Though the x-ray can raise suspicion of the diagnosis but the CT scan
is preferred because it not only important in localisation of the
broncho-pleural fistula but also in finding out the probable etiological
factor.
Figure 1: Diagnosis is
bronchopleural fistula.
A 54 year old man was not able to maintain saturation
CECT thorax shows connection (arrow) between left upper lobe segmental bronchi
and pleural space having air-fluid level. There is presence of loss of volume
on left side and also there is a cavitatory lesion in left apices with
aspergilloma in it. Diagnosis is bronchopleural fistula [1-6].
Bronchopleural fistula is fistulous communication between pleural cavity and bronchial tree secondary to some disease process or injury. It can be central when the pleural cavity communicates with trachea or lobar bronchus and peripheral when occur with segmental bronchi. It may present with fever, chest pain, dyspnoea and hypoxia. Falling fluid level along with expectoration of purulent or serosanguinous material is seen.
Key imaging diagnostic
clues
· Actual
connection may be demonstrated though rarely seen, but drop in fluid level is
seen after pneumonectomy.
· Development
of hydropneumothorax without any intervention or procedure.
Gas forming organisms
causing infection in pleural space Hydropneumothorax- may be iatrogenic.