Related Experiment Video
Updated: Mar 22, 2026
Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
Colopleural fistula caused by aspergillus: an extremely rare complication after lung resection-case report
Akio Hayashi1, Yoshiyuki Susaki2, Naoko Ose2
1Department of Thoracic Surgery, National Hospital Organization, Toneyama National Hospital, 5-1-1, Toneyama, Toyonaka, Osaka, 560-8552, Japan. aki-hayashi@kch.hosp.go.jp.
Abstract:
A colopleural fistula is a rare condition reported to be caused by Crohn's disease, a malignant tumor of the gastrointestinal tract, and other clinical conditions. Some studies have noted that a sub-diaphragmatic abscess, usually organized following abdominal surgery, may play some role in the formation of this type of fistula. Therefore, a colopleural fistula is a complication very rarely encountered by thoracic surgeons after lung resection.We experienced an extremely rare case of colopleural fistula following a left lower lobectomy for lung aspergillosis. Here, we report a 71-year-old man with a surgical history of proximal gastrectomy for gastric cancer. He underwent left lower lobectomy of the lung for aspergillosis, and a colopleural fistula occurred on the second operative day as a complication. Aspergillus might be responsible for forming a fistula between the colon and lung via the diaphragm, and lung surgery manifested this rare condition. Although some reports suggest that surgical treatment is mandatory to cure this fistula, an immediate colostomy in our case reduced the internal pressure of the colon, thus enabling spontaneous closure of the fistula with appropriate drainage and antibiotics. The patient was discharged in a good condition.
Insights
A rare colopleural fistula developed after lung surgery for aspergillosis. Immediate colostomy, drainage, and antibiotics allowed spontaneous closure, avoiding major surgery.
Area of Science:
- Thoracic Surgery
- Gastroenterology
- Infectious Diseases
Background:
- Colopleural fistula is a rare complication, often linked to gastrointestinal conditions or post-abdominal surgery abscesses.
- It is exceptionally uncommon following thoracic procedures like lung resection.
- Previous literature suggests surgical intervention is typically required for treatment.
Purpose of the Study:
- To report an extremely rare case of colopleural fistula following lung surgery.
- To discuss the potential role of Aspergillus in fistula formation.
- To highlight a conservative management approach for this rare complication.
Main Methods:
- Case report of a 71-year-old male patient.
- Patient underwent left lower lobectomy for lung aspergillosis.
- Management involved immediate colostomy, drainage, and antibiotic therapy.
Main Results:
- A colopleural fistula developed on the second postoperative day.
- The fistula potentially resulted from Aspergillus infection and lung surgery.
- Conservative management with colostomy led to spontaneous fistula closure.
Conclusions:
- This case demonstrates a rare instance of colopleural fistula post-lung resection.
- Aspergillus infection may contribute to the development of this fistula.
- Conservative management, including colostomy, can be effective in treating colopleural fistulas, challenging the necessity of immediate surgical repair.
Related Concept Videos
01:27Pneumothorax-II
Clinical Manifestations:
01:13Pleura of the Lungs
01:26Pneumothorax-I
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
01:25Pleural Effusion I: Introduction
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...