INCIDENTAL FINDING OF COLOPLEURAL FISTULA DURING PLEUROCUTANEOUS WINDOW SURGERY FOR EMPYEMA THORACIS

Abstract

We report a 35 year old male patient with a 43 day history of left sided chestpain, shortness of breath and fever. Before presenting to us, he was admitted ata local hospital, where left sided tube thoracostomy was performed for empyemathoracis. After failure of pus to resolve, he was referred to the Departmentof Thoracic Surgery at Dow University of Health Sciences, Karachi, Pakistan.Pus for gram stain and culture grew multiple organisms and antibiotics werestarted promptly. The patient’s condition did not improve, hence surgery wasplanned. During surgery, undigested food particles were found in the pleuralcavity along with foul smell, suggesting a diagnosis of enteropleural fistula. Bariumstudies confirmed the diagnosis of colo-pleural fistula. Adopting a stagedapproached, laprotomy and fistulectomy with primary closure of bowel wasattempted. Patient’s recovery was unremarkable and he was discharged aftereight days.