Hemorrhage due to inflammatory erosion of the pulmonary artery stump in postpneumonectomy bronchopleural fistula.

Bleeding from the pulmonary artery in patients with a bronchopleural fistula after pneumonectomy is a rare but devastating complication. The incidence is unknown, but our data suggest an incidence of 4% in all postpneumonectomy bronchopleural fistulas. Two case histories are presented in which the anterior transpericardial approach was used to stop the pulmonary bleeding by direct suturing. Nevertheless, 1 patient died 5 days later because of irreversible brain damage; the other patient recovered well after a protracted convalescence.