The role of computed tomography bronchography in the management of bronchopleural fistulas

J Thorac Imaging. 2010 Feb;25(1):W10-3. doi: 10.1097/RTI.0b013e31819d12f1.


The management of complex bronchopleural fistulas (BPFs) remains a major diagnostic and therapeutic challenge to all chest physicians. Successful management of a fistula revolves around treatment of the associated empyema cavity first. Definitive repair should be accomplished expeditiously to minimize the number of procedures performed. When treatment is protracted, secondary complications are more likely to develop and survival is adversely affected. Diagnosis and localization of a BPF is therefore paramount; however, it is sometimes difficult and may require multiple imaging studies and bronchoscopies. Herein, we describe our experience with computed tomography bronchography as a new technique for diagnosis and localization of difficult BPF. In addition, other modalities for diagnosis and medical management are discussed along with a relevant review of the literature.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Aged
  • Bronchial Fistula / diagnostic imaging*
  • Bronchial Fistula / surgery
  • Bronchial Fistula / therapy
  • Bronchography / methods
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Fibrin Tissue Adhesive / therapeutic use
  • Follow-Up Studies
  • Hemostatics / therapeutic use
  • Humans
  • Iohexol
  • Male
  • Middle Aged
  • Pleura / diagnostic imaging*
  • Pleura / surgery
  • Pleural Diseases / diagnostic imaging*
  • Pleural Diseases / surgery
  • Pleural Diseases / therapy
  • Radiographic Image Enhancement / methods
  • Tomography, Spiral Computed / methods
  • Tomography, X-Ray Computed / methods*


  • Contrast Media
  • Fibrin Tissue Adhesive
  • Hemostatics
  • Iohexol