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Ann Thorac Surg 2002;74:923-924
© 2002 The Society of Thoracic Surgeons

Case report

Simultaneous bronchopleural and esophagopleural fistulas after pneumonectomy

Walid Trigui, MDa, Françoise Le Pimpec-Barthes, MDa, Walid Shaker, MDa, Loïc Lang-Lazdunski, MD, PhDa, Marc Riquet, MD, PhD*a

a Service de Chirurgie Thoracique, Hôpital Européen Georges Pompidou, Paris, France

Accepted for publication April 1, 2002.

* Address reprint requests to Dr Riquet, Service de Chirurgie Thoracique, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
e-mail: marc.riquet{at}hop.egp.ap-hop-paris.fr

The simultaneous occurrence of bronchopleural fistula (BPF) and esophagopleural fistula (EPF) after pneumonectomy is very rare. We describe a 60-year-old man who developed empyema associated with bronchopleural fistula as a complication of a right pneumonectomy. Initial chest tube drainage and antibiotic therapy were ineffective. Five months later ingested food particles appeared in the drainage fluid. Esophagoscopy revealed an esophageal fistula of 10 mm in diameter. After nutritional support by feeding jejunostomy both BPF and EPF were repaired by subscapular muscle myoplasty and extensive thoracoplasty through a right thoracotomy. Endoscopic examination performed 1 month after surgery showed complete closure of both fistulas and 9 months after surgery the patient was eating and gaining weight. The patient’s death was due to aspiration pneumonia of another origin.




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