ABSTRACT
Esophageal duplication (ED) is rarely diagnosed in adults and is usually asymptomatic. Especially, ED that is connected to the esophagus through a tubular communication and combined with bronchoesophageal fistula (BEF) is extremely rare and has never been reported in the English literature. This condition is very difficult to diagnose. Although some combinations of several modalities, such as upper gastrointestinal endoscopy, esophagography, computed tomography, magnetic resonance imaging, and endoscopic ultrasonography, can be used for the diagnosis, the results might be inconclusive. Here, we report on a patient with communicating tubular ED that was incidentally diagnosed on the basis of endoscopy and esophagography during the postoperational evaluation of BEF.
Subject(s)
Adult , Humans , Bronchial Fistula , Diagnosis , Endoscopy , Endoscopy, Gastrointestinal , Endosonography , Esophageal Fistula , Esophagus , Fistula , Magnetic Resonance ImagingABSTRACT
Congenital bronchoesophageal fistula (BEF), congenital communication between esophagus and bronchus, is a rare malformation. Benign BEF shows only nonspecific symptoms that may delay a correct diagnosis and proper treatment. This is a case of a 3-year-old boy presenting congenital BEF with imperforate anus and atrial septal defect. He had recurrent pneumonia in the right lower lobe since he was 5 months old. A barium swallow examination showed a communicating fistula between the lower esophagus and the right lower lobe bronchus. Computed tomography scan supported to delineate the course of the fistula. He underwent resection surgery of the fistula and lobectomy of the right lower lobe. He recovered without any postoperative complications.
Subject(s)
Child , Humans , Anus, Imperforate , Barium , Bronchi , Esophagus , Fistula , Heart Septal Defects, Atrial , Pneumonia , Postoperative ComplicationsABSTRACT
Acquired bronchoesophageal fistula rare. Conservative treatment such as endoscopy is widely used. The recurrence rate after endoscopic treatment, however, is not well known. We report here on a case of a 54-year-old female who presented with recurrent bronchoesophageal fistula after endoscopic treatment that filled the fistula tract with Histoacryl(R).
Subject(s)
Female , Humans , Middle Aged , Endoscopy , Esophageal Diseases , Fistula , RecurrenceABSTRACT
Benign bronchoesophageal fistula is a rare disease and it may be characterized by nonspecific symptoms that can cause a delayed diagnosis. We misdiagnosed a patient with recurrent aspiration, which was due to bronchoesophageal fistula, as active pulmonary tuberculosis. The patient was 44 year old female who had suffered from chronic cough, especially during eating liquid meals, since 1982 when she had been treated for tuberculous lymphadenitis. Computed tomography showed an irregular mass with surrounding centrilobular nodules in the superior segment of the right lower lobe (RLL). She was diagnosed as having active pulmonary tuberculosis and treated with anti-tuberculosis medication, but she continued to complain of persistent cough even after anti-tuberculosis treatment. Thus, we reexamined the patient, and bronchoesophageal fistula between the esophagus and the superior segment of the RLL was finally confirmed by esophagography. After the fistula was surgically treated, the patient became asymptomatic and she then experienced good health.
Subject(s)
Female , Humans , Cough , Delayed Diagnosis , Eating , Esophagus , Fibrin Tissue Adhesive , Fistula , Meals , Rare Diseases , Tuberculosis , Tuberculosis, Lymph Node , Tuberculosis, PulmonaryABSTRACT
We report a case of bronchoesophageal fistula detected during induction of general anesthesia in brain abscess patient. Bubbling sound at substernal area and gas bubble at oral cavity during manually assisted mask ventilation, especially inspiration, were detected. Barium esophagography, gastroscopy and bronchoscophy were performed to know the nature of fistula after neurosurgical operation. The patient had a bronchoesophageal fistula due to unproperly treated old pulmonary tuberculosis. Esophageal opening of fistula located at midesophagus about 27 cm distance from incisor, while bronchial opening located at apical segment of right superior bronchus. It depends on the size, location, and duration of fistula to manifest clinical symptom. In bronchoesophageal fistula, the size of opening tends to be small and gradual symptom onset while relatively large and early in TEF. Therefore, knowledge of the differences of two types of fistula are essential to manage the patient who have these types of fistula.
Subject(s)
Humans , Anesthesia, General , Barium , Brain Abscess , Brain , Bronchi , Fistula , Gastroscopy , Incisor , Masks , Mouth , Tuberculosis , Tuberculosis, Pulmonary , VentilationABSTRACT
Broncholithiasis is uncommon in patients with silicosis. Bronchoesophageal fistula complicated by broncholithiasis is especially rare and only one case has been reported in Korea. Surgical treatment of broncholithiasis should be as conservative as possible to preserve the adequate pulmonary function. Meticulous dissection and division of the fistula with the interposition of viable tissues will prevent recurrence. We report a rare case of bronchoesophageal fistula complicated by broncholithiasis in a patient with silicosis.
ABSTRACT
Although the formation of fistula between esophagus and adjacent organ is a known complication of the self- expanding esophageal stent, only a few cases of surgically treated bronchoesophageal fistula have been reported. Increasing application of endoscopic stent for benign esophageal strictures increases the chance for this type of delayed complication. We experienced a case of bronchoesophageal fistula caused by esophageal stent for which we performed fistulectomy and Ivor Lewis operation simultaneously. To the best of our knowledge, this is the first report on the successful surgical treatment of this complication in Korea.
Subject(s)
Constriction, Pathologic , Esophagus , Fistula , Korea , StentsABSTRACT
Congenital bronchoesophageal fistula is a rare anomaly that may cause fatal complications if it goes unnoticed for many years. This anomaly may have various symptoms such as respiratory infections, coughing bouts when eating or drinking and even hemoptysis. Surgical resection is the treatment of choice and is definitive in almost cases. We report a case of type I congenital bronchoesophageal fistula misdiagnosed as chronic empyema thoracis with literature review.
Subject(s)
Cough , Drinking , Eating , Empyema , Fistula , Hemoptysis , Respiratory Tract InfectionsABSTRACT
Congenital bronchoesophageal fistula is a rare anomaly that may cause fatal complications if it goes unnoticed for many years. This anomaly may have various symptoms such as respiratory infections, coughing bouts when eating or drinking and even hemoptysis. Surgical resection is the treatment of choice and is definitive in almost cases. We report a case of type I congenital bronchoesophageal fistula misdiagnosed as chronic empyema thoracis with literature review.
Subject(s)
Cough , Drinking , Eating , Empyema , Fistula , Hemoptysis , Respiratory Tract InfectionsABSTRACT
Congenital bronchoesophageal fistula in the adult is rare, especially Braimbridge type III is very rare. We experienced congenital bronchoesophageal fistula associated intrapulmonary bronchogenic cyst. The patient was a 38-year-old male with chief complaints of coughing and abdominal pain 3 days before admission. Esophagogram revealed a fistulous tract between esophagus and cystic lesion in RLL. Fistulectomy and right lower and middle bilobectomy was performed. The postoperative course was uneventful.
Subject(s)
Adult , Humans , Male , Abdominal Pain , Bronchogenic Cyst , Cough , Esophagus , FistulaABSTRACT
Congenital bronchoesophageal fistula associated esophageal atresia usually presents in the newborn period or infancy but those without esophageal atresia are more insidious in disease process. Symptoms which include cough, hemoptysis, choking on swallowing liquids, uncommonly dysphagia, and epigastric discomfort may not begin until adult life. Most of the cases are curative unless there are serious underlying conditions. The diagnosis is usually made by gastroesophagoscopy, esophagogram, bronchogram and bronchoscopy. And the most of the cases can be cured by fistulectomy and resection of involved pulmonary lobes. We experienced one case of congenital bronchoesophageal fistula which occurred in a 13- year-old girl who complained of paroxysmal cough and intermittent hematemesis for 3 years.
Subject(s)
Adult , Child , Female , Humans , Infant, Newborn , Airway Obstruction , Bronchoscopy , Cough , Deglutition , Deglutition Disorders , Diagnosis , Esophageal Atresia , Fistula , Hematemesis , HemoptysisABSTRACT
Congenital bronchoesophageal fistula is a rare clinical entity in adults. This anomaly may cause various symptoms such as respiratory infections, coughing bouts when eating or drinking, and even hemoptysis. The fistula can cause symptoms in childhood but may not appear until adulthood. We recently experienced a case of congenital bronchoesophageal fistula associated with esophageal diverticulum in an adult. A 63-year-old woman was admitted to our hospital due to chest discomfort, sore throat and coughing bouts when eating. An empyema with lung abscess had occurred eight years previously. Results of the physical examination were unremarkable. A Barium swallowing revealed a medium-sized diverticulum at the right anterior aspect of the esophagus, which had developed a fistulous connection with the right lower lobe bronchus. The patient was treated by fistulectomy and lobectomy of the right lower lobe. The postoperative course was smooth and uneventful.
Subject(s)
Female , Humans , Bronchial Diseases/congenital , Bronchial Diseases/complications , Diverticulum, Esophageal/complications , Esophageal Diseases/congenital , Esophageal Diseases/complications , Fistula , Middle AgedABSTRACT
BACKGROUND: Congenital bronchoesophageal fistula(BEF) presented in adult life is a rare disorder and has characteristic clinical findings such as paroxysmal cough after water ingestion and recurrent respiratory infections. It usually manifested recurrent pneumonia and chronic cough with purulent phlegmon which was mis-or under-diagnosed as chronic bronchitis, bronchiectesis or lung abscess so forth. METHODS: We reviewed retrospectively 13 cases of congenital BEE in adult of Paik Hospital, College of Medicine, Inje University including 22 cases of congenital BEE previously reported in literature of Korea from 1979 through 1995. RESULTS: The mean age at diagnosis was 40.2 +/- 14.3. There was no difference in sex ratio(Male: Female 18 : 17). The mast common symptom was cough(91.4%), follwed by chronic sputum(74.3), hemoptysis(25.7), and paroxysmal nocturnal cough at specific position(20%). Twenty one of 31 patients who were able to review have the most specific sign, Ono's sign presented as paroxysmal cough after liquid ingestion. By classification of Braimbridge-Keith, Fourteen(45.1%) of 31 patients were group I (associated with esophageal diverticulum), 15(48.4%) were group II (simple fistula), and group III arid IV was one case in each. The opening of fistula confined to right lower lobe in 26(76.5%), left lower lobe in 6(176%), arid left main bronchus in 2(5.9%) cases. CONCLUSION: Congenital bronchoesophageal fistula is uncommon disorder which has characteristic histories and specific symptoms such as chronic and recurrent lower respiratory infections, and paroxysmal cough after liquid ingestion. Medical attention and careful history should be done in patients who have localized recurrent lower respiratory infections in right lower lobe.
Subject(s)
Adult , Female , Humans , Bees , Bronchi , Bronchitis, Chronic , Cellulitis , Classification , Cough , Diagnosis , Eating , Fistula , Korea , Lung Abscess , Pneumonia , Respiratory Tract Infections , Retrospective StudiesABSTRACT
There were so many causes of chronic coughing including postnasal drip, pneumonia, nasal polyp, asthma, interstinal lung disease etc. Congenital bronchoesophageal fistula was not usually thought as cause of chronic coughing. A 46-year-old female patient suffered from chronic coughing without usual causes. Her chest X-ray viewed normally. She coughed especially after swallowing foods. So we recommended her esophagogram and it revealed broncho-esphageal fistula. She underwent surgical resection of broncho-esophageal fistula. She was well without cough after the surgery. We reported a case of congenital broncho-esphageal fistula that had caused chronic coughing without any evidence of pneumonia, malignancy, tuberculosis, bronchiectasis, inflammation, asthma, nasal polyp, etc. So we should suspect the bronchoesophageal fistula when patients cough chronically with eating, and recommend the esophagogram.
Subject(s)
Female , Humans , Middle Aged , Asthma , Bronchiectasis , Cough , Deglutition , Eating , Fistula , Inflammation , Lung Diseases , Nasal Polyps , Pneumonia , Thorax , TuberculosisABSTRACT
Tracheal agenesis is the rare and uniformly lethal anomaly that presents with severe respiratory distress and aphonia after birth. In this anomaly, the trachea is usually absent and air is reaching the bronchi through a communication with the esophagus. The diagnosis should be suspected in a nowborn infant with respiratory distress whose intubation is difficult. We report an autopy case of tracheal agenesis, type 2 in a female newborn infant: Complete tracheal agenesis with the fistula between the esophagus and the carina. Associated anomalies were bilobed right lung, Meckel's divericulum and ventricular septal defect.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Aphonia , Autopsy , Bronchi , Diagnosis , Esophagus , Fistula , Heart Septal Defects, Ventricular , Intubation , Lung , Parturition , TracheaABSTRACT
Tuberculous bronchoesophageal fistula is a rare disease. We experienced a case of the tuberculous bronchoesophageal fistula, which was found by endoscopy and surgically confirmed. A sixty seven years old female patient complained of foreign body sensation in the throat and frequent aspiration, especially after liquid meal. Esophagoscopic ex- aminatian showed the orifice of the fistula in the midesophagus at the level of 28 cm from the incisors. Esophagogram showed bronchoesophageal fistula between midesophagus and the right intermediate bronchus. A bronchoscopy visualized fistulous tract with granulation in the right intermediate bronchus. Biopsy specimens obtained from the bronchus revealed the esophageal tissue with granulation and multinucleated giant cells. Fistulectomy with wrapping procedure was performed successfully. Surgical pathologic findings confirmed a small focal granuloma and chronic inflammations, compatible with tuberculosis. There was no evidence of malignancy at the specimens. She was treated with anti-tuberculous agents and became well.