Relapsed Benign Bronchoesophageal Fistula Caused by Advanced Esophageal Cancer

Abstract

Background. Bronchoesophageal fistula is often associated with pneumonia or thoracic empyema, and may sometimes follow a lethal course. This is a rare report of a relapsed bronchoesophageal fistula that was successfully treated using radical therapy. Case. The patient was a 63-year-old man who underwent endoscopic treatment for pulmonary esophageal fistula, caused by esophageal ulcer, four years earlier at another hospital. He presented to our hospital complaining of vomiting after meals for the past one month. Imaging demonstrated a relapsed bronchoesophageal fistula and subsequent pneumonia caused by esophageal obstruction due to lower thoracic esophageal cancer. After antibiotic therapy and total parenteral nutrition (TPN) management, we performed a right lower lobectomy and subtotal esophagectomy. The patient was discharged on the 15th day post-surgery and is currently undergoing outpatient chemotherapy. Conclusion. Based on the clinical course, the provisional diagnosis was relapsed bronchoesophageal fistula due to esophageal obstruction. Surgical treatment was successful after adequate improvement of the patient's general condition.