title: External fistulous wound with Pseudomonas aeruginosa infection and massive bleeding following rupture of pulmonary suppuration.
abstract: We present a 54-year old man with a pulmonary infectious cavity continuing to a cutaneous fistula. Before he was admitted to our hospital, he had undergone open-window surgery for a left thoracic empyema due to the rupture of pulmonary suppuration of the left upper lobe. He had then undergone thoracoplasty with the plombage of the cavity using left pectoralis major muscle. However, this procedure had failed and the external fistulous wound remained infected by Pseudomonas aeruginosa and occasional massive bleeding from the cavity occurred. He underwent en bloc left upper lobectomy for the external fistulous wound. The pedicled left latissimus dorsi muscle flap was transposed to fill the dead space and reinforce the bronchial stump. He remained in good health and did not experience intrathoracic infection or haemoptysis.
authors.affiliation: Department of Thoracic Surgery,  Kyoto University Hospital, Kyoto,  Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Miyata
authors.forename: Makoto
authors.initials: M
authors.lastname: Sonobe
authors.forename: Satoko
authors.initials: S
authors.lastname: Yamawaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D017577:Cutaneous Fistula / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D016724:Empyema, Pleural / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006470:Hemorrhage / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000601:surgery; D011552:Pseudomonas Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012086:Reoperation; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D013524:Surgical Flaps; D013905:Thoracoplasty / Q000379:methods; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure