Post-Intercostal Chest Drain Bronchopleural Fistula : A Clinical Study on Incidence, Risk Factors, and Outcomes in a Tertiary Care Centre

Background: Bronchopleural stula (BPF) is a serious complication associated with intercostal chest drain (ICD)insertion,especially ininfectiveandtubercularpleuraldiseases.Itleads toprolongedmorbidity,delayed recovery, and may require surgical intervention. Objective: To evaluate the incidence, clinical prole, and outcomes of patients developing bronchopleural stula following ICD insertion at a tertiary care center over a two-year period. Methods: A prospective observational study was conductedat GRMC, Gwalior,between January 2020and December 2022. Patients undergoingICD insertion for empyema, pneumothorax, or trauma were included. Persistent air leak (>7 days), radiological evidence of communication, and clinical signs suggestive of BPF were recorded. Data on etiology, management strategy, and outcomes were analyzed.Results: Out of 135 ICD insertions during the study period, 14 patients (10.3%) developed post-ICD BPF. The most common cause was tubercular empyema (8 cases), followed by necrotizing pneumonia (4) and chest trauma (2). Conservative management succeeded in 5 patients. Surgical management(decortication orlobectomy) was required in 9 cases. Mortality was reported in 2 patients. Conclusion: With an incidence >10%, post-ICD BPF is a clinically signicant complication, especially in infectious pathologies like tuberculosis. Timely diagnosisusingimagingandearlysurgicalinterventionarekeytoimprovingoutcomes.