A bronchopleural fistula is an abnormal passageway that develops between the large airways in the lungs (bronchial tree) and the membranes that line the lungs (pleura). The condition is a serious complication of lung cancer surgery. Bronchopleural fistulas may also occur following severe lung infections, a pneumothorax, chemotherapy or radiation therapy for lung cancer, or with tuberculosis.
If a bronchopleural fistula develops, air that is breathed in may travel through this passageway into the space between the layers that line the lungs.
With lung cancer surgery where a portion of a lung or a whole lung are removed, this complication occurs in up to 28% of people. It is more likely to occur with extensive surgeries such as pneumonectomy, and less common with less invasive surgeries like a lobectomy or a wedge resection.
Treatment may include surgery to close the fistula, or a bronchoscopy, during which a chemical is inserted into the fistula. The chemical creates inflammation in the fistula that leads to scarring and closure of the passageway, in essence "gluing" the abnormal passage shut.
Lois, M. and M. Nagen. Bronchopleural Fistulas. An Overview of the Problem With Special Focus on Endoscopic Management. Chest. 2005. 128(6):3955-3965.