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Ann Thorac Surg 2004;77:324-326
© 2004 The Society of Thoracic Surgeons

Case report

Empyema resulting from a true colopleural fistula complicating a perforated sigmoid diverticulum

Kostas Papagiannopoulos, MMEDa*, Dimitrios Gialvalis, MDa, Ibrahim Dodo, MRCSa, Mike J. Darby, MDb

a Cardiothoracic Surgery, Leeds General Infirmary, Leeds, United Kingdom
b Radiology, Leeds General Infirmary, Leeds, United Kingdom

Accepted for publication April 29, 2003.

* Address reprint requests to Dr Shiraishi, Division of Pediatrics, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan 602-8566.
e-mail: isao{at}koto.kpu-m.ac.jp

Empyemas developing after traumatic rupture of intraabdominal organs have been previously reported. We report a case of a true nontraumatic colopleural fistula following surgery for spontaneous rupture of a sigmoid diverticulum. The diagnosis was suspected by the presence of an air-containing tract seen in a computerized tomogram of chest and abdomen and was established with a contrast study. The empyema cavity was initially drained, followed by a laparotomy and fistulectomy with primary large bowel anastomosis and loop ileostomy. Although rare, colopleural fistulas present a diagnostic challenge and delayed management can lead to increased morbidity.




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