Abstract
We encountered a patient with esophagobronchial fistula accompanying benign esophagealulcer in whom evident endoscopic findings could be obtained, and preservative treatmentachieved healing. The patient was a 73-year-old female. After partial hepatectomy, upperdigestive tract endoscopy revealed reflux esophagitis. Therefore, a protective factor-enhancingagent was administered at the outpatient clinic. However, about l year later, the patient wasadmitted for epigastric pain. Upper digestive tract endoscopy revealed esophageal ulcer. At theulcer base, a ffistula was detected. Endoscopy, esophageal fluoroscopy, and abdominal computedtomography (CT) suggested esophagobronchial fistula. Therefore, fasting and preservativetreatment, including drip infusion and administration of H2 blockers, proton pump inhibitors(PPI), and antibiotics, were performed for about l month. As a result, the u.lcer showedcicatrization, and the fistula Was completely closed. The present case suggests that esophago-bronchial fistula can be diagnosed by endascapy when the fistula is present in the loweresophagus and air bubbles spout from the site with respiration. Furthermore, surgery isconsidered the first-choice treatment for esophagobronchial fistula. However, in some patientswith benign ulcer-related esophagobronchial fistula, preservative treatment achieves healing.Initially, preservative treatment should be considered.
