A bronchopleural fistula (BPF) is a

fistula A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...

between the

pleural space The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication bet ...

and the lung. It can develop following

pneumonectomy A pneumonectomy (or pneumectomy) is a surgical procedure to remove a lung first successfully done in 1933 by Dr. Evarts Graham. This is not to be confused with a lobectomy or segmentectomy, which only removes one part of the lung. There are two ...

, 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 A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and shortness of breath. In a minority of cases, a one-way valve i ...

or other loss of pleural negative pressure, especially during positive pressure

mechanical ventilation Mechanical ventilation, assisted ventilation or intermittent mandatory ventilation (IMV), is the medical term for using a machine called a ventilator to fully or partially provide artificial ventilation. Mechanical ventilation helps move a ...

. On imaging, the diagnosis is suspected indirectly on radiograph. Increased gas in the

operative bed, or new gas within a loculated effusion are highly suggestive of the diagnosis. Infectious causes include

tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, i ...

, ''

Actinomyces israelii ''Actinomyces israelii'' is a species of Gram-positive, rod-shaped bacteria within the genus ''Actinomyces''. Known to live commensally on and within humans, ''A. israelii'' is an opportunistic pathogen and a cause of actinomycosis. Many physi ...

'', '' Nocardia'', and '' Blastomyces dermatitidis''. Malignancy and trauma can also result in the abnormal communication.

References

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External links

BRONCHOPLEURAL FISTULA
Intensive Care Unit, Prince of Wales Hospital, Chinese University of Hong Kong Diseases of pleura