[Post Fenestrated Thoracic Empyema with Broncopleural Fistula, Healed Successfully without Plombage]

A 60-year-old man was performed right middle and lower bilobectomy. High fever was observed on the 17th postoperative day and the patient was diagnosed as having empyema with bronchopleural fistula(BPF). Chest tube drainage and antibiotics were started followed by open window thoracotomy on the 61st postoperative day. The repetition of closing package procedure was done daily or every other day. BPF was successfully covered by good granulation and was healed 6 months after open thoracotomy. The empyema cavity gradually decreased in size, and was completely epithelized 1 year after fenestration. Usually, the treatment of empyema with BPF is surgical treatment such as muscle flap plombage, following open window thoracotomy. But if the fistula is small and the infection is controlled effectively non-surgical treatment following open window thoracotomy is potentially useful way to cure the empyema with BPF.