New method for detection of a bronchopleural fistula: direct instillation of Tc-99m DTPA into the pleural space via a thoracostomy tube

Clin Nucl Med. 1998 Jun;23(6):353-5. doi: 10.1097/00003072-199806000-00003.

Abstract

A 65-year-old man who had undergone a right upper lobectomy for squamous cell carcinoma developed a persistent air space in the right superior thorax. Because a bronchopleural fistula was suspected, a new technique to demonstrate the fistula was used. Five mCi of Tc-99m DTPA was instilled through a pigtail catheter into the cavity. Radiotracer activity extended into the remaining right bronchial tree, trachea, and left bronchial tree on the 10 minute delayed image confirming the presence of a bronchopleural fistula. Using bronchoscopic guidance, the fistula was sealed with a fibrin plug. A repeat examination 4 days later revealed no extension of tracer from the cavity up to 60 minutes after instillation, indicating successful sealing of the fistula. This technique offers a rapid, inexpensive, and portable diagnosis of bronchopleural fistula.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bronchial Fistula / diagnostic imaging*
  • Chest Tubes
  • Fistula / diagnostic imaging*
  • Humans
  • Male
  • Pleural Diseases / diagnostic imaging*
  • Radionuclide Imaging
  • Radiopharmaceuticals*
  • Technetium Tc 99m Pentetate*
  • Thoracostomy

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Pentetate