Successful surgical treatment of bronchopleural fistula caused by severe pulmonary tuberculosis: A case report and review of literature

Figure 1 Chest computed tomography scans of patient. A: At admission and before surgery show bilateral pulmonary infection and complete compression and atelectasis of the right lung. Postoperative chest computed tomography (CT) demonstrates right lung expansion; B: Chest CT scan showing the destruction of the right upper lung; C: Both the presence of pus in the pleural cavity and iodine gauze in the emphysematous pleural space are observed. The residual cavity is eliminated after surgery; D: The coarctation of the right intercostal space is noted on chest CT. The patient’s right chest wall deformity has almost resolved, 6 months after the operation.

Figure 2 Bronchoscopic view of the right upper bronchus. A: Bronchoscopy at admission shows a 5 mm fistula (white arrows) of the right upper bronchus, along with erythema, erosion, and hyperplasia of the apical bronchus, and a small amount of necrotic material; B: Bronchoscopy is performed 1 mo after the anti-tuberculosis treatment; C: Bronchoscopy is performed 6 mo after the anti-tuberculosis treatment.

Figure 3 The timeline of treatment and procedures. TB: Tuberculosis; BPF: Bronchopleural fistula.

Figure 4 Intraoperative and postoperative findings. A: Open-window thoracostomy was performed on the patient; intraoperatively, mold was noted on the pleural surface; B: No effusions were noted in the pleural cavity and no lesions were seen on the pleural surface.