Treatment of Bronchopleural Fistula (ulceration)
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Bronchopleural fistula is a formation of ulceration between the bronchi and pleural cavity. Bronchial fistulas are one of the most difficult conditions in pulmonary diseases. This condition can be either congenital or acquired. This condition is rare, it develops in 0.03% of newborns. In adults, bronchopleural fistula can develop as a complication. It occurs in 2-30% of the complications of lung resection.
Bronchial fistulas can be singular, 62% of cases, or ulceration can become multiple, 38%. In adults bronchopleural fistula can develop as a result of trauma, serious infection and as a complication after surgery, such as lung resection, as it had been mentioned above.
Bronchopleural fistula can also develop in the severe cases of tuberculosis, lung abscess, acute destruction of the lungs. Rarely, bronchopleural fistula can develop as a result of pneumothorax or disintegration of a cancerous tumor. Overall, the most common cause of bronchopleural fistula is postoperative complication.
It is important to undergo regular check-up after the lung or chest surgery to avoid development of complications. Undergoing radiotherapy or chemotherapy for lung cancer, can also affect the lungs and create development of ulceration.
Nonetheless, bronchopleural fistula is a rare condition and it mostly develops in adults. Babies need to be checked for the signs of cyanosis or any breathing difficulties after the birth in case they have lung problems.
- Coughing
- Fever
- Chills
- Weakness
- Headache
- Poor appetite
- Weight loss
- Chest pain
- Blue skin
- During a general examination the doctor will listen to the lungs of the patient with a stethoscope. The doctor will rule out other conditions which can be causing similar symptoms.
- The doctor will ask the patient about previous pulmonary diseases which could have caused development of ulceration. The doctor will review the medical history of the patient to determine if he/she had any surgery and if there had been any complications.
- Radiography and other imaging tests, such as MRI and CT scan, can be used to examine the lungs more closely and determine if there is ulceration.
- Conservative treatment can be used before and after the surgery to assist with breathing and also make the recovery faster. If bronchopleural fistula was caused by infections, the infections can be treated with antibiotics.
- An oxygen therapy can be used in case a person needs more oxygen into the lungs.
- Surgical closure of the fistula is a surgery used to treat the ulceration and restore normal breathing of the patient.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko