Injection of Contrast Media in Postresection Pleural Spaces; Diagnostic, Prognostic and Therapeutic Value

1.Injection of bronchographic contrast medium into post-thoracotomy spaces is a useful procedure because it: a) demonstrates the presence or absence of a bronchopleural fistula; b) exactly outlines the size of the space and in the majority of cases the bronchial communication or communications; c) enables the surgeon to make an early decision concerning the need for further surgery on the basis of the above findings.2.In almost half of the patients who had injection of bronchographic contrast into residual spaces, these spaces closed relatively soon following the procedure. Based upon our experience, the use of bronchographic contrast media, as described above, is not only a diagnostic procedure but also has prognostic and possibly therapeutic value in patients with post-thoracotomy spaces.3.The three features of importance in deciding that a space will not close and surgery is indicated are: a) the presence of a large bronchopleural fistula; b) a space of such large size that its closure is improbable; c) the failure of a space into which contrast media has been injected to shrink or lose its air-fluid level within three weeks following the injection.