Bronchial Fistula

a pathological canal between the lumen of a bronchus and a cavity in the lung, pleural cavity, any internal organ, or the skin surface. A bronchial fistula may develop when there are penetrating wounds of the thorax and after lung surgery; more rarely, it may occur as a result of purulent diseases of the lungs. Bronchial fistulas consist either of canals that are single from beginning to end or of canals that originate from several bronchi and end in several openings—so-called reticular, or latticed, bronchial fistulas. Bronchial fistulas are manifested by elevation of temperature, moderate dyspnea, a cough with mucopurulent or bloody sputum, sometimes with an admixture of imbibed liquid; upon introduction of medications into the pleural cavity, the patient may taste and smell them when exhaling. X-ray examination is of prime value in the diagnosis of bronchial fistula. Treatment may consist of a combination of pleural punctures with bronchoscopy and pumping out the contents along with intrabronchial introduction of special medicinal substances; more often treatment is effected by surgery.