Multislice CT in the diagnosis of bronchopleural fistula

1. Santa Casa de Porto Alegre, Porto Alegre (RS) Brasil. 2. Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil. A 55-year-old man underwent right upper lobe resection after sustaining a chest injury in an automobile accident. An air leak persisted for 5 days after the surgery. On the fifteenth postoperative day, the patient was referred to our emergency ward due to respiratory difficulty. Examination confirmed that he was experiencing mild respiratory difficulty; RR was 25 breaths/min and HR was 98 bpm. Examination of the respiratory system revealed subcutaneous emphysema and the absence of pulmonary sounds in the right hemithorax. A chest X-ray showed right hydropneumothorax. A multislice CT scan confirmed this finding, and multiplanar reconstruction demonstrated the presence of a bronchopleural fistula in the anterior segment of the right lower lobe (Figure 1). Video-assisted thoracoscopic surgery and antibiotics were used in order to manage this lesion.