Bronchoesophageal fistulas secondary to coccidioidomycosis

Thoracoscopic treatment of a broncho-esophageal fistula: A case report

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Broncho-Esophageal Fistula (BEF) in adults is rare.

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If left untreated, BEF may lead to fatal complications despite its benign nature.

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The most frequent approach is thoracotomy.

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Video Assisted Thoracoscopic Surgery (VATS) may be a minimally invasive approach.

Introduction

Broncho-esophageal fistula is a rare clinical condition which can be manifested with non-specific signs and symptoms.

Presentation of a case

Here, we report an adult case of a broncho-esophageal fistula in a 43-year-old man referred for chronic cough after fluid food intake and weight loss. Barium swallow, esophagogastroduodenoscopy, bronchoscopy and Computed Tomography of the chest demonstrated a broncho-esophageal fistula between the apical segmental bronchus of the lower right lobe and the middle section of the esophagus. The patient underwent video-assisted thoracoscopic surgery for resection of the fistula. No post-operative complications occurred.

Discussion

Broncho-esophageal fistula in adults is rare and its diagnosis is often delayed due to the frequent lack of specific symptoms. Although there is no standard protocol, the most widely used treatment is thoracotomy with identification and dissection of the fistula tract followed by repair of bronchial and esophageal defects.

Conclusions

Video-assisted thoracoscopic surgery appears to be an effective and minimally invasive approach for the treatment of broncho-esophageal fistulas, especially in young, healthy subjects.