Bronchopleural Fistula or Alveolopleural Fistula?

Ease of Use of Watanabe Spigot for Alveolopleural Fistulas

“…3,4 A BPF is a communication between a mainstem, lobar, or segmental bronchus and the pleural space. An APF is a communication between the pulmonary parenchyma distal to a segmental bronchus and the pleural space.…”

Facing the challenges of perioperative air leaks using water seal in Colombia

“…Anatomically, air leaks result from either bronchopleural fistulas (BPF) or alveolar-pleural fistulas, generating two completely different pathologies, and therefore treatment approaches. [9][10][11][12][13] BPF are pathologic communications between the main stem, lobar, segmental, or sometimes sub-segmental bronchi and the pleural space; whereas alveolar-pleural fistulas are communications between the pulmonary parenchyme distal to the subsegmental bronchi and the pleural space.…”

“…These fistulas may not resolve on water seal alone, thus bronchoscopic and surgical interventions are required. [10][11][12][13][14][15][16][17] In the context of trauma, alveolar-pleural fistulas are referred to as minor leaks and correspond to grade II-III lung injuries. These generally result from tractotomies, pneumorrhaphies, sublobar resections, or the trauma itself.…”

“…Grade 0 indicates no leak, grade 1 corresponds to a single bubble escaping the water seal, grade 2 corresponds to a stream of bubbles, and grade 3 corresponds to a group or coalescence of bubbles. [10][11][12][13][14][15][16][17] This helps to determine which patients may remain on water seal or merit bronchoscopic evaluation (Table 2). Other physiological factors that may influence bubble escape, such as endexpiratory pressure, lung expansion, and the patient's respiratory strength should be taken into consideration.…”

“…When air leaks progress beyond 5-7 days, they are defined as prolonged (Table 3). [12][13][14][15][16] Approach to air leaks in Colombia…”