Free latissimus dorsi muscle flap for chronic bronchopleural fistula

The author presents experience with the treatment of chronic bronchopleural fistula in a patient who suffered a gunshot injury to his right chest. During the primary assessment the patient underwent resection of two lobes of the right lung, and the patient healed without complications. Four years later the patient presented with bronchopleural fistula with empyema. We had to proceed with right sided pneumonectomy and close up the fistula. The fistula recurred, and the patient underwent repeated operations by chest surgeons without success. Finally, the situation was solved by a contralateral latissimus dorsi muscle free flap. The free-flap was wrapped around the bronchial stump, and the muscle also filled the chest cavity. We discuss the post-surgical course and present the final result.