Skip to main content
Log in

Fatal bronchovascular fistula after lobectomy visualized through postmortem computed tomography angiography: A case report

  • Case Report
  • Published:
Forensic Science, Medicine, and Pathology Aims and scope Submit manuscript


False aneurysm of the pulmonary artery complicated by bronchovascular fistula formation represents a rare life threating condition. We report a case of fatal hemoptysis after formation of a bronchial fistula in the late postoperative period after sleeve lobectomy. Cause of death was determined by external postmortem examination, post mortem computed tomography (PMCT) and angiography (PMCTA) without conventional autopsy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others


  1. Shaaban H, Sharma H, Rao J, Clark S. A pulmonary artery false aneurysm after right middle lobectomy: a case report. J Med Case Rep. 2007;1(1):70.

    Article  Google Scholar 

  2. Forcillo J, Liberman M, Gorgos A, Ferraro P. Repair of a bronchovascular fistula four years after right carinal pneumonectomy. Ann Thorac Surg. 2013;95(6):2152–3.

    Article  Google Scholar 

  3. Poplausky MR, Rozenblit G, Rundback JH, Crea G, Maddineni S, Leonardo R. Swan-Ganz catheter-induced pulmonary artery pseudoaneurysm formation: three case reports and a review of the literature. Chest. 2001;120(6):2105–11.

    Article  CAS  Google Scholar 

  4. Fliss B, Bartsch C, Flach PM, Thali MJ, Ampanozi G. Fatal aorto-esophageal fistula detected on postmortem computed tomography angiography. J Forensic Radiol Im. 2015;3(3):182–5.

    Article  Google Scholar 

  5. Ross S, Spendlove D, Bolliger S, Christe A, Oesterhelweg L, Grabherr S, et al. Postmortem whole-body CT angiography: evaluation of two contrast media solutions. AJR. 2008;190(5):1380–9.

    Article  Google Scholar 

  6. Grabherr S, Dominguez A, Mangin P. Post-mortem angio-CT: a new diagnostic approach. Rev Med Suisse. 2011;7(303):1507–10.

    CAS  PubMed  Google Scholar 

  7. Schweitzer W, Flach PM, Thali M, Laberke P, Gascho D. Very economical immersion pump feasibility for postmortem CT angiography. J Forensic Radiol Im. 2016;5:8–14.

    Article  Google Scholar 

  8. Chevallier C, Doenz F, Vaucher P, Palmiere C, Dominguez A, Binaghi S, et al. Postmortem computed tomography angiography vs. conventional autopsy: advantages and inconveniences of each method. Int J Legal Med. 2013;127(5):981–9.

    Article  Google Scholar 

  9. Rashid SN, Bouwer H, O'Donnell C. Lethal hemorrhage from a ureteric-arterial-enteric fistula diagnosed by postmortem CT angiography. Forensic Sci Med Pathol. 2012;8(4):430–5.

    Article  Google Scholar 

  10. Burton JL, Rutty GN. The hospital autopsy. In: Burton J, Rutty G, editors. The hospital autopsy. 2nd ed. London: Arnold; 2001. p. 60–77.

    Google Scholar 

  11. Coast GC, Gee DJ. Traumatic subarachnoid hemorrhage - an alternative source. J Clin Pathol. 1984;37(11):1245–8.

    Article  CAS  Google Scholar 

  12. Maxeiner H. Detection of ruptured cerebral bridging veins at autopsy. Forensic Sci Int. 1997;89(1–2):103–10.

    Article  CAS  Google Scholar 

  13. McLean JM, Wright RM, Henderson JP, Lister JR. Vertebral artery rupture associated with closed head injury. Report of two cases. J Neurosurg. 1985;62(1):135–8.

    Article  CAS  Google Scholar 

  14. Karhunen PJ, Mannikko A, Penttila A, Liesto K. Diagnostic angiography in postoperative autopsies. Am J Forensic Med Pathol. 1989;10(4):303–9.

    Article  CAS  Google Scholar 

  15. Zerlauth JB, Doenz F, Dominguez A, Palmiere C, Uske A, Meuli R, et al. Surgical interventions with fatal outcome: utility of multi-phase postmortem CT angiography. Forensic Sci Int. 2013;225(1–3):32–41.

    Article  Google Scholar 

  16. Samano MN, Saka JA, Caramori ML, Pego-Fernandes PM, Jatene FB. Fatal bronchovascular fistula after a single lung transplantation: a case report. Clinics. 2009;64(10):1031–3.

    Article  Google Scholar 

  17. Piciche M, De Paulis R, Fabbri A, Chiariello L. Postoperative aortic fistulas into the airways: etiology, pathogenesis, presentation, diagnosis, and management. Ann Thorac Surg. 2003;75(6):1998–2006.

    Article  Google Scholar 

  18. Nunley DR, Gal AA, Vega JD, Perlino C, Smith P, Lawrence EC. Saprophytic fungal infections and complications involving the bronchial anastomosis following human lung transplantation. Chest. 2002;122(4):1185–91.

    Article  Google Scholar 

  19. Sihvo EIT, Sioris T, Tynninen O, Salo JA. Fatal fistula between the trachea and the brachiocephalic artery: late complication of a second-generation, self-expanding metallic tracheal stent. J Thorac Cardiovasc Surg. 2006;131(6):1415–6.

    Article  Google Scholar 

  20. Pirrelli S, Bozzani A, Arici V, Odero A. Endovascular treatment of acute haemoptysis secondary to aortobronchial fistula. Eur J Vasc Endovasc Surg. 2006;32(4):366–8.

    Article  CAS  Google Scholar 

  21. Jeannin A, Saignac P, Palussiere J, Gekiere JP, Descat E, Lakdja F. Massive systemic air embolism during percutaneous radiofrequency ablation of a primary lung tumor. Anesth Analg. 2009;109(2):484–6.

    Article  Google Scholar 

  22. Ebert LC, Ptacek W, Breitbeck R, Furst M, Kronreif G, Martinez RM, et al. Virtobot 2.0: the future of automated surface documentation and CT-guided needle placement in forensic medicine. Forensic Sci Med Pathol. 2014;10(2):179–86.

    Article  Google Scholar 

  23. Steffen C, Schaepman M, Hardmeier T, Schweitzer W. Digital 3D reconstruction of two parahissian accessory bundles in a case of Wolff-Parkinson-White syndrome. Int J Legal Med. 2004;118(2):101–5.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Philipp Hinderberger.

Ethics declarations


The authors express their gratitude to Emma Louise Kessler, MD for her generous donation to the Zurich Institute of Forensic Medicine, University of Zurich, Switzerland.

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hinderberger, P., Fliss, B., Thali, M.J. et al. Fatal bronchovascular fistula after lobectomy visualized through postmortem computed tomography angiography: A case report. Forensic Sci Med Pathol 13, 234–239 (2017).

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: