A Case of Broncho-esophageal Fistula Associated with Bronchiectasis

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 malignant and chronic inflammation such as tuberculosis and have favorable

outcome with proper treatment. To our knowledge, there huts 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.