Correct!
4. 1 and 3

The chest x-ray shows a large right pneumothorax with a horizontal air-fluid interface indicating a hydropneumothorax. The density seen that could be confused with a catheter is actually fluid in the fissure. Note how it ends at the air-fluid interface and does not extend outside the chest. The large hydropneumothorax combined with the clinical symptoms of fever and productive cough suggest a bronchopleural fistula, a communication between a main stem, lobar, or segmental bronchus and the pleural space.

A chest tube was inserted which made little difference in the patient's symptoms or radiographic appearance.

Which of the following are true regarding bronchopleural fistulas? (Click on the correct answer to proceed to the fifth and final panel)

1. Bronchoscopy with a Fogarty catheter can be used to isolate the bronchopleural fistula
2. Can occur with necrosis of lung cancer during chemo or radiation therapy
3. Endobronchial valves may help reduce the pneumothorax
4. 1 and 3
5. All of the above

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