Two Cases of Congenital Esophagobronchial Fistula in Adults

Abstract

We reported two adult cases of congenital esophagobronchial fistula. Case 1 is a 65-year-old female who had a history of chronic cough. She was admitted to our hospital because of a fistula revealed by barium esophagogram, which was performed in a mass survey. Chest CT demonstrated an esophagobronchial fistula in the middle of the thoracic esophagus, which was connected to the right B6. Bronchoscopy was performed. Outflow of the pigment medium from the right B6 was detected, as the medium was infused through a tube that passed into the esophagus. Resection of the fistula was performed. Pathological examination showed that the fistula was covered with squamous epithelium and had muscularis mucosa. Congenital esophagobronchial fistula was diagnosed.
Case 2 is a 57-year-old male who was admitted with fever and hemoptysis. Esophagography in a previous mass survey revealed a fistula from the esophagus to the right bronchus. Chest CT showed an esophagobronchial fistula. Esophagoscopy revealed a diverticulum and an orifice of the fistula. Existence of a fistula between the esophagus and the right B6 was demonstrated by the same technique using the pigment medium as in Case 1. Resection of the fistula and right lower lobectomy were performed. Inflammatory changes were found in the surrounding tissues of the residues of the fistula. Based on the patient's history, we conjectured that the lung abscess probably had resulted from leakage of food through the fistula.
These findings suggest that chest CT can play an important role in the early diagnosis of an esophagobronchial fistula.