A Case Report of Congenital Esophagobronchial Fistula with Esophageal Diverticulum

Abstract

A case of congenital esophagobronchial fistula with an esophageal diverticulum is described. The patient is a 53-year-old male. Esophago-gastro-duodenogram was carried out with contrast medium as part of a complete medical chekcup. This revealed a diverticulum in the left side of the middle-third intra-thoracic esophagus. In addition, a bronchus of the left inferior lobe was seen at the base of the diverticulum. The opening of the fistula was recognized at the bottom of the esophageal diverticulum with an esophagoscope. But the opening of a fistula was not able to be identified with a bronchoscope. An outflow of the pigment medium from the left B⁶was recognized, as the medium was infused therough a tube that passed into the esophagus. An operation to resect the diverticulum and the fistula was carried out. Pathological findings showed that the lumen of the fistula was covered with stratified squamous epithelium and accompanying smooth muscle. Multi-layer ciliated epithelium was seen at a part of the periphery. One section showed migration between squamous epithelium and ciliated epithelium. 55 cases of this disease have been reported in Japan, including this case. But the case of a fistula to the left bronchus is rare. This case is the eighth report in Japan.