2018 Volume 32 Issue 2 Pages 221-225
A decreased pleural fluid level on a chest radiograph after pneumonectomy suggests the existence of a bronchopleural fistula (BPF) in the bronchial surgical margin. A rare asymptomatic etiology, known as benign emptying of the postpneumonectomy space (BEPS), has been reported to exist when BPF is not detected. We report a suspected case of BEPS after left pneumonectomy.A 65-year-old male underwent left pneumonectomy after the diagnosis of squamous cell lung cancer in the left lower lobe. A decreased fluid level in the left thoracic space was detected on a radiograph at 47 postoperative days (POD). However, the patient had no related respiratory symptom and bronchoscopy revealed no fistula in the bronchial surgical margin. Exploratory video-assisted thoracic surgery was performed at 99 POD, but no sign of BPF was noted. During the follow-up period, the fluid level began to increase at 175 POD and the air space in the left thoracic cavity had completely disappeared at 225 POD. No decrease in the pleural fluid level was seen at one year and nine months after the operation. We should take into consideration BEPS that does not necessitate medical treatment if a decreased pleural fluid level is detected on a chest radiograph after pneumonectomy.
