ABSTRACT
A 68-yr-old man complaining of sudden, postprandial chest pain visited the emergency room. His symptom had been aggravated during the preceding two days. Upper gastrointestinal contrast study with gastrographin showed leakage of dye from the epiphrenic diverticulum in the lower third of the esophagus. The primary repair was urgently carried out. Upper gastrointestinal contrast study 14 days after operation revealed an esophageal leakage which was small and confined. The patient was managed with conservative treatments such as intravenous hyperali-mentation and broad-spectrum antibiotics. Forty-two days after the operation, a gastrographin swallow study showed the absence of leaks. This is the first report-ed case of a perforated epiphrenic esophageal diverticulum repaired by delayed primary repair in Korea.
Subject(s)
Aged , Humans , Male , Diverticulum, Esophageal/complications , Esophageal Perforation/diagnosis , Esophagectomy/methods , Time Factors , Treatment OutcomeABSTRACT
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
A young male who had minimal dysphagia since childhood complained of increasing difficulty in swallowing for a few months. Upper Gastrointestinal endoscopy was normal on two occasions done by two gastroenterologists. Barium swallow showed minimal extrinsic pressure on the oesophageal wall. X-ray chest was normal. CT scan showed a large growth close to the oesophagus. Resection of the growth showed a carcinoma completely filling an oesophageal diverticulum with a normal oesophageal lumen.