A Case of Broncho-esophageal fistula associated with Bronchiectasis.

Chung, Hyuck Joon; Ku, Sung Hyun; Lee, Sun Min; Park, Kwang Joo; Hwang, Sung Chul; Lee, Yi Hyeong; Han, Myung Ho; Kim, Yung Jin; Lee, Chul Ju; Lee, Ki Bum

doi:1999.46.5.729

Tuberc Respir Dis > Volume 46(5); 1999 > Article

Case Report

Tuberculosis and Respiratory Diseases 1999;46(5):729-734.
DOI: https://doi.org/10.4046/trd.1999.46.5.729 Published online May 1, 1999.

A Case of Broncho-esophageal fistula associated with Bronchiectasis.

Hyuck Joon Chung, Sung Hyun Ku, Sun Min Lee, Kwang Joo Park, Sung Chul Hwang, Yi Hyeong Lee, Myung Ho Han, Yung Jin Kim, Chul Ju Lee, Ki Bum Lee

¹Department of Pulmonology, Ajou University, College of Medicine, Suwon, Korea.
²Department of Thoracic Surgery, Ajou University, College of Medicine, Suwon, Korea.
³Department of Pathology, Ajou University, College of Medicine, Suwon, Korea.

Abstract

Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment. To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.

Key Words: Broncho-esophageal fistula, Bronchiectasis, Hemoptysis