[A case of empyema with bronchopleural fistula associated with diabetes and renal failure treated utilizing omental and muscle flap].

The patient was a 75-year-old male who had a right empyema with bronchopleural fistula, which had developed after right upper lobectomy for pulmonary tuberculosis performed 18 years previously. He also had diabetes and renal dysfunction. The fistula failed to close 5 months after open drainage thoracotomy. Accordingly, closure was performed by the intrathoracic transposition of an omental and muscle flaps obtained from the right latissimus dorsi, pectoralis major, and pectoralis minor. At 70 days after the closure, the fistula reopened due to his poor nutritional state, but it closed again spontaneously following intravenous hyperalimentation. In those patients who have empyema with bronchopleural fistula associated with diabetes or renal dysfunction, long-term postoperative care, especially nutritional management, is necessary because of their poor general health condition.