"Double fistula" bronchopleural and pleurocutaneous during radioxenon study

A woman had a right pneumonectomy, complicated 5 years later by an anaerobic infection with a following "blowout" of the bronchial stump; an empyema developed. A muscle graft was used to close the bronchial stump. An Eloesser flap was created to allow drainage of the empyema. She was later admitted with respiratory distress. A ventilation lung scan was performed with Xe-133. This showed the results of a "double fistula," with passage of radioxenon into the right pleural space and then out of the body through the Eloesser flap.