Bronchoesophageal fistula following irradiation and bronchial arterial infusion ; a case report

Abstract

A 39-year-old man was admitted with the chief complaint of cough. Chest X-ray and CT scan showed a large mass in right hilum, and bronchoscopy showed complete obstruction of the truncus intermedius by an intrabronchial tumor. He underwent 60Co irradiation (20 Gy × 20) and bronchial arterial infusion. Forty days after the second infusion, he developed a bronchoesophageal fistula. Right sleeve pneumonectomy and subtotal esophagectomy were performed. The esophagus was repaired with a stomach roll with omentum. Bronchial and esophageal anastomose were wrapped with an omental pedicle flap. Both anastomose were healed well. However, he died 67 days after operation from a brain metastasis which was not evident before operation. Treatment for malignant bronchoesophageal fistula is still difficult. This report describes one-stage surgical repair of a bronchoesophageal fistula.