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.
Source:
Lois, M. and M. Nagen. Bronchopleural Fistulas. An Overview of the Problem With Special Focus on Endoscopic Management. Chest. 2005. 128(6):3955-3965.
