Bronchial stump fistula (BSF) is a known complication after lobectomy, although its incidence after lobe resection for non-small cell lung cancer usually does not exceed 2%. We present the case of a patient in whom a late BSF developed that led to a fatal pulmonary hemorrhage 4 weeks after right upper lobectomy and 4 hours after emergency readmission. Such a pulmonary hemorrhage could have been prevented by pulmonary artery embolization and intrapericardial pneumonectomy. The decision to perform pneumonectomy as a preventative procedure without overt clinical symptoms was a difficult decision to reach, particularly given the likelihood of being unnecessarily aggressive.
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Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.