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Spontaneous bronchopleural fistula following lung volume reduction surgery for emphysema

^a Heart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
^b Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA

*Corresponding author. UPMC Presbyterian, 200 Lothrop St., Suite C-800, Pittsburgh, PA 15213, USA. Tel.: +1 412-647-4786; fax: +1 412-647-3104.

E-mail address: gilbsx{at}upmc.edu (S. Gilbert).

Five days following bilateral thoracoscopic lung volume reduction surgery for emphysema, a 63-year-old man underwent reoperation for closure of a massive bronchopleural fistula. It was discovered intraoperatively that the fistula was located distant from prior staple lines or resection sites from his surgery. This case is an example of what may be a unique pathophysiologic mechanism of bronchopleural fistula formation – a ‘stress rupture’ of the lung parenchyma following lung volume reduction surgery.

Key Words: Bronchoscopy/bronchus; Fistula; Lung volume reduction; Emphysema; Thoracoscopy/VATS