Niaz Hussain, Aneeqa Ahsan Zafar.
Incidental finding of colopleural fistula during pleurocutaneous window surgery for empyema thoracis.
Pak J Chest Med Jan ;20(4):151-3.

We report a 35 year old male patient with a 43 day history of left sided chest pain, shortness of breath and fever. Before presenting to us, he was admitted at a local hospital, where left sided tube thoracostomy was performed for empyema thoracis. After failure of pus to resolve, he was referred to the Department of Thoracic Surgery at Dow University of Health Sciences, Karachi, Pakistan. Pus for gram stain and culture grew multiple organisms and antibiotics were started promptly. The patient’s condition did not improve, hence surgery was planned. During surgery, undigested food particles were found in the pleural cavity along with foul smell, suggesting a diagnosis of enteropleural fistula. Barium studies confirmed the diagnosis of colo-pleural fistula. Adopting a staged approached, laprotomy and fistulectomy with primary closure of bowel was attempted. Patient’s recovery was unremarkable and he was discharged after eight days.

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