THE TREATMENT OF BRONCHIAL FISTULAS

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Abstract
A bronchial fistula is a communicating fistulous tract between a bronchus and the pleural surface of the lung or of the cutaneous surface of the thoracic wall. Anatomically, there are bronchopleural and bronchocutaneous fistulas. The fistula may be lined by epithelium throughout, so that the bronchial mucosa is continuous with the thoracic skin, or both ends may be lined by epithelium for certain distances and the intervening space may or may not be covered by a granulating surface. A bronchopleural fistula results with an accompanying pneumothorax when a lung abscess ruptures into the pleural cavity. Small bronchopleural fistulas are encountered sometimes in treating an acute empyema, or when operating for a chronic empyema. A bronchocutaneous fistula may exist in connection with a chronic empyema. Often it constitutes the principal condition that causes the patient to seek treatment. Bronchocutaneous fistulas are most often due to operative intervention in the case of

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