New method for detection of a bronchopleural fistula: direct instillation of Tc-99m DTPA into the pleural space via a thoracostomy tube.
A 65-year-old man who had undergone a right upper lobectomy for squamous cell carcinoma developed a persistent air space in the right superior thorax. Because a bronchopleural fistula was suspected, a new technique to demonstrate the fistula was used. Five mCi of Tc-99m DTPA was instilled through a pigtail catheter into the cavity. Radiotracer activity extended into the remaining right bronchial tree, trachea, and left bronchial tree on the 10 minute delayed image confirming the presence of a bronchopleural fistula. Using bronchoscopic guidance, the fistula was sealed with a fibrin plug. A repeat examination 4 days later revealed no extension of tracer from the cavity up to 60 minutes after instillation, indicating successful sealing of the fistula. This technique offers a rapid, inexpensive, and portable diagnosis of bronchopleural fistula.
Obuchowski
C A
CA
Department of Radiology, Western Pennsylvania Hospital, Pittsburgh 15224, USA.
Joyce
J M
JM
Foster
R
R
Bennett
M
M
D000368:Aged; D001983:Bronchial Fistula / Q000000981:diagnostic imaging*; D015505:Chest Tubes; D005402:Fistula / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D010995:Pleural Diseases / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate; D013907:Thoracostomy
D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate