Idiopathic colopleural fistula presenting with lung abscess and refractory empyema:A case report  

作　　者：Chun-Li Wang Kung-Chuan Cheng 

机构地区：[1]Division of Colorectal Surgery,Department of Surgery,Kaohsiung Chang Gung Memorial Hospital,Kaohsiung 833,Taiwan

出　　处：《World Journal of Gastrointestinal Surgery》2023年第4期740-744,共5页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Colopleural fistula is a rare condition,and only a limited number of cases have been reported.Here,we report a case of idiopathic colopleural fistula in an adult without any known predisposing factors.The patient presented with a lung abscess and refractory empyema and was successfully treated with surgical resection.CASE SUMMARY A 47-year-old man with a history of lung tuberculosis,which had been completely cured 4 years ago,presented to our emergency department with a productive cough and fever for 3 d.Tracing his history,he had undergone left lower lobe segmentectomy of the left lung due to lung abscess one year ago at another hospital.However,he developed refractory empyema postoperatively despite surgical intervention including decortication and flap reconstruction.After admission,we reviewed his previous medical images and noted a fistula tract between the left pleural cavity and splenic flexure.In addition,according to his medical records,bacterial culture of the thoracic drainage showed growth of Escherichia coli and Bacteroides fragilis.Our lower gastrointestinal series and colonoscopy confirmed the diagnosis of colopleural fistula.The patient underwent a left hemicolectomy,splenectomy,and distal pancreatectomy,and the diaphragm was repaired under our care.No further empyema recurrence was noted during follow-up.CONCLUSION Indicative signs of colopleural fistula include refractory empyema accompanied by the growth of colonic flora in the pleural fluid.

关 键 词：Colopleural fistula Lung abscess EMPYEMA Colonic flora Case report 

分 类 号：R521.7[医药卫生—内科学]