Bronchopleural fistula vs lung abscess

Following are the main differentiating features of bronchopleural fistula and lung abscess on plain radiographs and CT 1

Bronchopleural fistula

  • bronchopleural fistulas have mostly lenticular shape of space
  • length of air fluid level in bronchopleural fistula in different projections is unequal
  • contiguous to chest in at least one projection and make an obtuse angle (> 90 degrees)
  • split pleura sign is often present
  • displace vessels and airways
  • thin, uniform, smooth walls on both aspects
  • adjacent consolidation may be absent
  • sometimes extend into costophrenic angle
  • may cross fissures
  • sometimes change shape of space with posture

Lung abscess

  • lung abscesses are spherical
  • length of air fluid level in lung abscesses in different projections is approximately equal
  • often separate from chest on all aspects and make acute angle (<90 degrees)
  • does not show split pleura sign
  • does not displace vessels and airways
  • thick, non uniform and irregular wall on both aspects
  • adjacent consolidation is usually present
  • does not extend into costophrenic angle
  • does not cross fissures
  • does not change in shape of space with posture
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Article information

rID: 47282
System: Chest
Section: Gamuts
Tags: cases, refs
Synonyms or Alternate Spellings:
  • Difference between bronchopleural fistula and lung abscess

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