The operative management of acute post-pneumonectomy bronchopleural fistula after flush bronchial amputation.

Acute disruption of the bronchial closure after pneumonectomy causes severe problems in patient management. Radical attempts at closure of the fistula and space obliteration (thoracoplasty) carry a high mortality. The management of this condition by a series of staged operative procedures is described. Pneumonectomy has usually been performed for bronchogenic carcinoma and prognosis is therefore guarded. Several low-risk operative interventions, with discharge from hospital between procedures, provide a safe and effective management method in the case described.