bronchopleural fistula


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Related to bronchopleural fistula: pneumothorax

fistula

 [fis´tu-lah] (pl. fistulas, fis´tulae) (L.)
any abnormal tubelike passage within body tissue, usually between two internal organs or leading from an internal organ to the body surface. Some fistulas are created surgically for diagnostic or therapeutic purposes; others occur as result of injury or as congenital abnormalities. Among the many kinds of fistulas, the anal type (fistula in ano) is one of the most common. It generally develops as a result of a break or fissure in the wall of the anal canal or rectum, or an abscess there. Treatment is by surgery.

In women, difficult labor in childbirth may result in formation of a vesicovaginal fistula between the bladder and the vagina with resulting leakage of urine into the vagina. In a vesicointestinal fistula, there is leakage of urine from the bladder into the intestine. In a rectovaginal fistula, feces escape through the wall of the anal canal or rectum into the vagina. This condition, formerly a serious hazard of childbirth, is now rare; like other kinds of fistula, it can be corrected by surgery.

With the types of fistulas described here, typical symptoms are pain in the affected region and an abnormal discharge through the skin near the anus or through the vagina. Fistulas at different places of the body may be caused by tuberculosis, actinomycosis (a fungus infection), the presence of diverticula, or certain other serious diseases, and the fistula itself may be a site of infection and discomfort.
abdominal fistula one between a hollow abdominal organ and the surface of the abdomen.
anal fistula (fistula in a´no) one opening on the cutaneous surface near the anus, which may or may not communicate with the rectum.
arteriovenous fistula one between an artery and a vein, either pathologic (such as a varicose aneurysm) or surgically created to ensure an access site for hemodialysis. The site must be allowed 6 to 8 weeks to mature before it can be cannulated. Such a fistula may be the anastomosis of a natural artery and vein, a bovine graft, or a synthetic polytetrafluoroethylene (PTFE) graft. The bovine graft is taken from the bovine carotid artery and anastomosed to the vein and artery of the patient. In a PTFE graft, fibers are woven into a mesh called Gore-Tex and made into a sleeve and flange; this is available in a variety of sizes.

Precautions necessary to insure patient safety when caring for an individual with an arteriovenous fistula include frequent assessments for adequate circulation in the fistula and the distal extremity. A bruit or thrill can be heard over the access site. Blood pressure measurements, withdrawal of blood, injections, and administration of intravenous fluids should not be done on the extremity with such a fistula.
Internal arteriovenous fistulas.
blind fistula one open at one end only, opening on the skin (external blind fistula) or on an internal surface (internal blind fistula).
branchial fistula a persistent pharyngeal groove (branchial cleft).
Brescia-Cimino fistula an arteriovenous fistula for hemodialysis access, connecting the cephalic vein and radial artery.
bronchopleural fistula one between a bronchus and the pleural cavity, causing an air leak into the pleural cavity; sometimes seen as a complication of empyema, fibrosis, or pneumonia.
cerebrospinal fluid fistula one between the subarachnoid space and a body cavity, such as from head trauma or bone erosion, with leakage of cerebrospinal fluid, usually in the form of rhinorrhea or otorrhea.
complete fistula one extending from the skin to an internal body cavity.
craniosinus fistula one between the cerebral space and a paranasal sinus, permitting escape of cerebrospinal fluid into the nose.
Eck's fistula an artificial communication made between the portal vein and the vena cava.
enterocutaneous fistula see enterocutaneous fistula.
enterovesical fistula one connecting some part of the intestine with the urinary bladder; called also vesicoenteric f.
fecal fistula one between the colon and the external surface of the body, discharging feces.
gastric fistula
1. one communicating between the stomach and some other body part.
2. a passage created artificially through the abdominal wall into the stomach.
horseshoe fistula one near the anus, having a semicircular tract with both openings on the skin.
incomplete fistula blind fistula.
perilymph fistula rupture of the round window with leakage of perilymph into the inner ear, so that changes in middle ear pressure directly affect the inner ear, causing sensorineural deafness as well as dizziness, vertigo, nausea, and vomiting. Head trauma and dramatic changes in atmospheric pressure are the most common causes. The usual treatment is restriction in activity (sometimes with complete bed rest), so that the fistula can heal. Surgical repair may be necessary, consisting of placement of a graft over the defect.
pilonidal fistula pilonidal sinus.
pulmonary arteriovenous fistula a congenital fistula between the pulmonary arterial and venous systems, allowing unoxygenated blood to enter the systemic circulation.
rectovaginal fistula one between the rectum and vagina.
rectovesical fistula one between the rectum and urinary bladder.
salivary fistula one between a salivary duct or gland and the cutaneous surface, or into the mouth through an abnormal pathway.
thoracic fistula one communicating with the thoracic cavity.
umbilical fistula one communicating with the intestine or urachus at the umbilicus.
urinary fistula any fistula communicating between the urinary tract and another organ or the surface of the body.
vesicoenteric fistula (vesicointestinal fistula) enterovesical fistula.
vesicovaginal fistula one from the bladder to the vagina.

bron·cho·pleu·ral fis·tu·la (BPF),

communication between a bronchus and the pleural cavity; usually caused by necrotizing pneumonia or empyema; also may follow pulmonary surgery or irradiation.
Synonym(s): BP fistula

bronchopleural fistula

A communication between the pleural space and the bronchial tree. While such fistulas are rare, they are clinically problematic as they are associated with high morbidity and mortality.

Aetiology
Post-pulmonary resection, lung necrosis complicating infection, persistent spontaneous pneumothorax, chemo- or radiotherapy for lung cancer and tuberculosis.

Management
Various surgical and medical procedures with use of bronchoscopy and various glues, coils and sealants.

bron·cho·pleu·ral fis·tu·la

(BPF) (brong'kō-plūr'ăl fis'tyū-lă)
Communication between a bronchus and the pleural cavity; usually caused by necrotizing pneumonia or empyema; also may follow pulmonary surgery or irradiation.
Synonym(s): BP fistula.
References in periodicals archive ?
* All cases of empyema complicated by bronchopleural fistula are difficult to manage and needed major surgery.
Noppen, "Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management," Chest, vol.
We hypothesize that bronchopleural fistula contributed to treatment failure with intrapleural tPA and dornase.
Called bronchopleural fistulas, these wounds are holes that lead from the large airways in the lungs to the membrane that lines the lungs.
In addition, we will discuss the imaging features of complex pleural-parenchymal abnormalities, with special consideration of bronchopleural fistulas, unexpandable lung, and post-pneumonectomy complications.
Rupture of the pneumatocele will cause pneumothorax or the formation of bronchopleural fistula (BPF) especially during mechanical ventilation, which was the case with this infant.
After MS and selective ventilation of the left lung, the right main bronchus was opened and the foreign body removed, with repair of the bronchopleural fistula. A second child presented with a chronically obstructed left main bronchus with destruction of the entire left lung.
(7) Bronchopleural fistula tracts are usually present but can be difficult to detect by CT.
Bronchopleural fistula is a very serious complication post-operative lung resection associated with significant morbidity and a mortality of up to 67% (1) It has a reported incidence of up to 20% post pneumonectomy (2).
Postpneumonectomy empyema with or without bronchopleural fistula is a rare but extremely serious complication of surgery that can have devastating effects on patients and families.
Bronchopleural Fistula (BPF) was suspected when chest x-ray PA view before thoracentesis showed horizontal air fluid level and persistence of air bubbling through the intercostal tube drainage system beyond 24 hours after tube thoracostomy.
Bronchopleural fistula (BPF) is an infrequently encountered complication in intensive care units (ICU) in patients who have not undergone thoracic surgery [1] and poses difficulty in ventilator management.