[Postoperative bronchopleural fistula--diagnostic significance of masked cases and results of early re-operation].
We studied recent-day cases of postoperative bronchopleural fistula from 1982 to 1985. And in 1985, postoperative chest X-ray films were intensively compared with previous ones. Radiological signs for bronchopleural fistula and/or alveolar fistula such as increases in air content and/or falls in air-fluid level of pleural space were seen in 11 (7.1%) of 155 pulmonary resection cases in 1985. Among them, 8 of these cases were confirmed as bronchopleural fistulas. So one half of cases with these radiological findings were bronchopleural fistulas. But 2 of these 8 cases were masked bronchopleural fistulas which were not recognizable by bronchofiberscope and soon or later, bronchopleural fistulas developed which were recognizable by bronchofiberscope. For differential diagnosis between the bronchopleural fistula and alveolar fistula, serial chest X-ray films which was compared with previous one, were useful. In masked bronchopleural fistula cases, abnormal findings as mentioned above were seen more than three times, but in alveolar fistula cases were seen less than two times. On the bronchoscopic examination, bronchopleural fistulas were mainly located at the side of the residual lobe on the stump. Bronchopleural fistula cases which were re-operated for re-amputation, re-suture, and coverage of the stump within 48 hours, were all cured. So we concluded early re-operation is the best choice for bronchopleural fistula patient, because of short administration, no cosmetical problems and no disadvantage for lung function.
Sato
M
M
Saito
Y
Y
Fujimura
S
S
Sagawa
M
M
Ota
S
S
Nagamoto
N
N
Imai
S
S
Suda
H
H
Nakada
T
T
Hashimoto
K
K
D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005402:Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010995:Pleural Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011013:Pneumonectomy; D011183:Postoperative Complications