Abstract
A 64-year-old man was referred to our hospital because of a neck tumor. Thoracic esophageal cancer with lymphatic metastasis to the neck was diagnosed, and he was given chemoradiotherapy. During therapy, the original lesion disappeared, but recurred 3 months later. Then, salvage surgery was undertaken and the postoperative course was satisfactory. However, 3 months later, he was transferred to our hospital again because of severe respiratory failure due to acute pneumonia. CT and bronchoscopy revealed a fistula between the right main bronchus and reconstructed gastric role. There was difficulty with mechanical respiration because of air leakage. Thus, we decided to emergently stent the right main bronchus. The fistula was closed temporarily by a metallic covered stent, but the next day the stent cover broke. Then, we changed to a silicon stent (Dumon stent), but the fistula could not be closed effectively. He required thoracotomy for fistula closure but he was judged to not be capable of tolerating surgery due to his poor general condition. Therefore, we created a jejunostomy under general anesthesia to improve his nutritional state. However, postoperatively his respiratory condition worsened rapidly and he died.
