Four adult patients underwent operations for congenital esophago-bronchial fistulas. There were one woman and three men, with an age range of 37 to 43 years (mean 40.5 years). All patients have had severe cough and sputa since childhood, so they have been treated as pneumonia, chonic bronchitis and so on.
Barium swallow pointed out esophago-bronchial fistulas in all cases. The esophageal opening of the fistula existed at the middle intra-thoracic esophagus in all cases. And the bronchial side opened at the right B10, right B6, right truncus intermedius and left B6. According to Braimbrige's classification, one case belonged to type I; another one, to type II; and the remaining two, to type III.
Resection of the fistulous tract was performed in one case, and resection of the fistula with lobectomy was done in the remaining three cases. All patients did well postoperatively, and they are free from any symptoms. By histological observations, esophageal mucosa and muscularis propria were seen in all cases, and the transition from esophageal to bronchial mucosa could be confirmed in two cases.
When we examine patients who have had respiratory infection frequently since childhood, a possible presence of esophago-bronchial fistula.