CTICasesBronchopleural Fistula Post-Esophagectomy
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Imaging findings
Post-esophagectomy, the patient developed a chronic mediastinal collection at the site of the anastomosis, covered by an omental flap. Follow-up CT, particularly on lung windows, revealed a discrete defect in the wall of the left main bronchus, directly adjacent to this collection. Subsequent bronchoscopy confirmed a small fistula between the left main bronchus and the mediastinal collection.
Key takeaways
Bronchopleural (or broncho-mediastinal) fistulas are serious complications of esophagectomy and other thoracic surgeries, especially in the context of anastomotic leaks and chronic collections. CT can often localize these fistulas as discrete defects in the airway wall communicating with an adjacent collection. Bronchoscopy is diagnostic and can guide intervention. Potential causes include thermal injury, instrumentation during surgery, or erosion from infection.
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