A CASE OF AN ACQUIRED ESOPHAGO-BRONCHIAL FISTULA SUCCESSFULLY TRSATED BY ENDOSCOPIC LASER COAGULATION THERAPY

Abstract

A 64-year-old man, who had had repeated mediastinitis due to esophageal fistuia, was transferred to our hospital for the further examination and therapy. His chest X-ray and CT scan on admission showed pneumonia and thickened wall of the lower esophagus. Esophago-gram revealed a fistula with a diameter of about 1 mm on the left wall. Esophagoscopy showed air leaking through the orifice of the fistula. A diagnosis of an acquired esophago-bronchial fisutula was made. We performed the endoscopic laser coagulation to close the fistula using Nd-YAG laser. Two months after the treatment, either esophagogram or esophagoscopy demon-strated no evidence of fistula. There was no complication in the course of the treatment. Pneumonia or mediastinitis has not occured for 4 years after the treatment. Our experiellce suggests that Nd-YAG laser therapy is a safe and effective treatment for acquired esophageal fisutula.