Laissy J P, Valverde J P, Cohen G, Nussaume O, Grenier P
J Radiol. 1986 Mar;67(3):171-7.
Case reports of 110 patients undergoing pneumonectomy were reviewed to assess value of standard postoperative chest radiography for detection of early complications, consisting mainly of empyema and/or bronchopleural fistula. Most radiologic modifications observed do not represent abnormal findings, although two signs can contribute to the radiologic diagnosis of empyema: the central superimposed air/fluid levels and the secondary mediastinal displacement, but even these signs are inconstant and of late onset. Five signs may be of significance for the diagnosis of bronchopleural fistula: in addition to the two described above there are the rapid fall in principal air/water level, the increase in subcutaneous emphysema and the late onset contralateral alveolar syndrome. The diagnosis of a bronchopleural fistula prior to the development of clinical symptoms was possible in one of two cases.