2016 Volume 38 Issue 4 Pages 301-305
Background. Recanalization of tracheoesophageal fistula in congenital esophageal atresia has been reported even after surgical treatment. Case. A 35-year-old woman who was admitted to our hospital for further examination of bronchiectasis, had undergone surgical treatment of congenital esophageal atresia in the neonatal period. She had suffered from refractory pneumonia after high school. Chest X-ray film showed infiltrative shadow with air fluid levels in the left lower lung field. Chest CT showed bronchiectasis with retention of fluid and bronchopneumonia in the left lower lobe. Bronchoscopy showed leakage of fluid from a fistula in the membranous portion of the trachea. We speculated on the possibility of the recanalization of the tracheoesophageal fistula. Endoscopy also showed fistula in the anterior esophageal wall and esophagography showed the fistula communicating between the trachea and the esophagus. We diagnosed recanalization of the tracheoesophageal fistula and treated by fistulectomy after antibiotic treatment for bronchopneumonia. It was suggested that repeated intratracheal aspiration through the fistula caused refractory bronchopneumonia, leading to bronchiectasis in the left lower lobe. Conclusion. In cases of bronchiectasis with refractory bronchopneumonia who had previously been treated for congenital esophageal atresia in the past, we should suspect recanalization of tracheoesophageal fistula.
