Right subcutaneous-pleural fistula

(A) Chest frontal radiograph in a patient who underwent a right lower lobe lobectomy complicated by a postoperative air leak. A large right basal hydropneumothorax with gas-liquid level is visible. An additional pocket of gas with a level is seen in the axillary soft tissues of the right hemithorax. These findings are suggestive of fistula development between the pleural space and the nearby subcutaneous tissue.
(B) Axial images from chest computed tomography performed in the same patient confirms the presence of a large right hydropneumothorax with a right-sided subcutaneous-pleural fistula due to a postoperative defect in the right side of the rib cage.