A CASE OF ESOPHAGO-MEDIASTINAL ABSCESS THAT UNDERWENT FISTULA FORMATION TO THE ESOPHAGUS AFTER ENDOBRONCHIAL ULTRASOUND-GUIDED TRANSBRONCHIAL NEEDLE ASPIRATION

Abstract

We report a rare case of esophago-mediastinal abscess that subsequently underwent fistula formation to the esophagus after endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). A 65-year-old man consulted our hospital because of hoarseness and loss of appetite. Endoscopy and CT revealed that the left recurrent laryngeal nerve was paralyzed and a mediastinal lymph node was swollen. A respiratory physician performed EBUS-TBNA of the swollen mediastinal lymph node. Thirty-seven days after the procedure, the patient consulted our department because he again experienced loss of appetite. Laboratory examination revealed elevation of inflammation markers. CT revealed that the mediastinal lymph node was enlarged and had become an abscess. Therefore, he was hospitalized for treatment. Esophagogastroduodenoscopy on the third hospital day showed an esophageal ulcer at the anterior wall of the middle intrathoracic esophagus and we suspected fistula formation. Based on these findings, he was diagnosed with esophago-mediastinal abscess that underwent fistula formation to the esophagus. He was treated conservatively. The fistula disappeared and his condition gradually improved. He was discharged on the 41st hospital day.