Empyema resulting from a true colopleural fistula complicating a perforated sigmoid diverticulum.
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.
Papagiannopoulos
Kostas
K
Department of Cardiothoracic Surgery, Leeds General Infirmary, Leeds, United Kingdom. kpagiannopoulos@yahoo.com
Gialvalis
Dimitrios
D
Dodo
Ibrahim
I
Darby
Mike J
MJ
D003108:Colonic Diseases / Q000150:complications*; D004240:Diverticulum / Q000601:surgery*; D016724:Empyema, Pleural / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology*; D016156:Respiratory Tract Fistula / Q000150:complications*; D012422:Rupture, Spontaneous; D012810:Sigmoid Diseases / Q000601:surgery*