Bronchopleural Fistula

Etiology: necrotizing pneumonia or blunt trauma or chest tube causes communication between bronchus and pleural space
CXR: may first manifest as a hydropneumothorax
CT: clear communication between air in bronchus and air in pleural space

Cases of Bronchopleural Fistula

CXR of bronchopleural fistula — CXR AP shows a large right pleural effusion with an air-fluid level within it – a hydropneumothorax – that is being drained by a chest tube.

CT of bronchopleural fistula — Axial CT without contrast of the chest shows consolidation of the right lower lobe with multiple air pockets within it giving the appearance of necrotic lung, a large loculated right empyema that contains an air pocket, and one of the air pockets in the right lower lobe appears to be in continuity with the air pocket in the pleural space suggesting the presence of a bronchopleural fistula.