Fistulas between the Esophagus and Adjacent Vital Organs in Esophageal Cancer

ABSTRACT

Esophageal fistulas may occur in an advanced stage or as a potentially life-threateningcomplication of treatment. They can be divided into esophageal-respiratory and esophageal-aorta fistulas. The diagnosis is confirmed with fluoroscopy using dilute barium oralcontrast, followed by thin-section computed tomography, which defines the precise locationand extent of the fistula. Flexible esophagoscopy and bronchoscopy are requiredfor confirmation and anatomic assessment of the suspected fistula and provide additionalinformation for treatment planning. Contamination is traditionally controlled by surgicalexclusion, along with a jejunal feeding tube. Currently, fully covered self-expanding metalstents are the primary treatment option.