An unusual case of malignant oesophago-pulmonary fistula diagnosed by multidetector computed tomography

Satija, Lovleen; Joshi, Pratibha; George, Richard A.; Singh, Samarjeet

doi:10.1016/s0377-1237(11)60108-1

Cited by 9 publications

(17 citation statements)

References 3 publications

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“…As their name suggests, ERFs are defined as abnormal communications between the esophagus and respiratory system, either of congenital or acquired etiology [ 1 ]. Congenital fistulae are mostly diagnosed in the neonatal period, whereas acquired fistulae are more commonly detected in adults [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Of all ERFs, the esophagotracheal subtype is the most common (52–57%), followed by the esophageal bronchial (37–40%) and esophageal pulmonary (3–11%) subtypes [ 4 ]. Nontumoral causes include infections, such as granulomatous mediastinal diseases, or traumatic lesions, such as iatrogenic complications after prolonged intubation, upper respiratory and digestive endoscopic procedures or surgical interventions, as well as Crohn’s disease [ 1 , 3 , 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Esophageal, lung, or mediastinal cancers are the main malignancies responsible for ERFs [ 1 ]. Approximately 15% of tracheal cancers, 5% of esophageal cancers, and 0.2% of lung malignancies have been reported as causing esophageal pulmonary fistulae [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Acquired esophageal respiratory fistulae (ERFs) of the esophageal tracheal or esophageal bronchial type are well-recognized complications of malignant neoplasms, infections, traumatic lesions, or surgery of the esophagus or tracheobronchial tree [ 1 ]. On the contrary, esophagopulmonary fistulae are very uncommon life-threatening conditions.…”

Section: Introductionmentioning

confidence: 99%

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Esophageal pulmonary fistula – a rare complication of radiation therapy: a case report

et al. 2018

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BackgroundEsophageal respiratory fistulae are abnormal communications between the esophagus and the respiratory system. They are either congenital or acquired. Most acquired esophageal respiratory fistulae are of the esophageal tracheal and esophageal bronchial type and are caused by infections or malignant neoplasms, whereas esophageal pulmonary fistulae are rare.Case presentationWe report a case of a 72-year-old Caucasian man with squamous cell carcinoma of the lung presenting with abrupt-onset dyspnea during localized mediastinal radiotherapy. His laboratory test results suggested major respiratory infection. A chest x-ray revealed left apical lung radiopacity along with excavated lesions, consistent with secondary tumor infection. No clinical improvement was observed despite antibiotic treatment. A contrast-enhanced computed tomographic scan of the chest confirmed persistent lung infection with unfavorable progression and air in the mediastinum; the latter suggested a fistula from the upper third of the esophagus to the upper left pulmonary lobe. Videofluoroscopy confirmed the diagnosis of an acquired esophageal pulmonary fistula. The patient underwent endoscopy, and an esophageal self-expandable metallic stent was deployed.ConclusionsEsophageal pulmonary fistulae must be suspected whenever patients undergoing local mediastinal radiotherapy present with acute pulmonary complications, particularly pneumonia resistant to antibiotic treatment. Esophageal pulmonary fistulae are diagnosed by means of radiological imaging. Because esophageal respiratory fistulae are acute life-threatening conditions, prompt treatment with an endoscopically placed covered stent proves vital.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Esophageal pulmonary fistula – a rare complication of radiation therapy: a case report

et al. 2018

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“…On rare occasions, the fistulous tract can directly erode in the lung parenchyma. 8 Nowadays, CT virtual bronchoscopy is also being used as an adjunct to aid in the diagnosis of the precise site of these fistulae. 9 Most of these patients present with a non-resolving pneumonia.…”

Section: Complication Patients (N=27)mentioning

confidence: 99%

Thoracic Complications of Oesophageal Carcinoma- A Retrospective Analysis of Ct Appearances

Joshi¹

2017

jebmh

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BACKGROUND Oesophageal cancer is a common gastrointestinal tract malignancy and Computed Tomography (CT) is generally used for its initial evaluation and staging. Due to the anatomical relationships of the oesophagus, malignancies afflicting it can also give rise to various pulmonary and thoracic complications. The staging CT can also be used to detect and evaluate these complications. Detection of concurrent thoracic complications in addition to the primary malignancy is imperative to institute appropriate management. The aim of the study is to analyse and discuss the various thoracic complications in cases of oesophageal carcinoma detected on Multidetector Computed Tomography (MDCT). MATERIALS AND METHODS MDCT images of 27 cases of histopathologically-proven carcinoma oesophagus who had thoracic complications in addition to features of malignancy and metastases were retrospectively analysed. The various pulmonary and thoracic complications in addition to the primary lesions were assessed and evaluated. RESULTS There were 27 cases of oesophageal carcinoma with complications, of which there were 20 patients who had pulmonary consolidation/pneumonitis, 5 had oesophago-respiratory fistulae, 1 had a lung abscess, 2 had pericardial effusions, 3 had pleural effusions, 2 cases of airway compromise with atelectasis and 2 cases with Pulmonary Thromboembolism (PTE). CONCLUSION The routine chest CT for evaluation and staging of the primary tumour in cases of oesophageal carcinoma can also reveal thoracic complications directly or indirectly related the cancer some of which may alter management. The most common of these are pneumonia and oesophago-respiratory fistulas. Others like pulmonary thromboembolism may require immediate intervention. An awareness of the spectrum of imaging appearances of these complications and due vigilance while interpreting chest CT studies will aid decision making and institution of appropriate management.

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A rare cause of esophagopleural fistula due to intensity-modulated proton therapy: a case report and review of literature

Ali

Challa

Siddiqui

et al. 2021

Clin J Gastroenterol

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An unusual case of malignant oesophago-pulmonary fistula diagnosed by multidetector computed tomography

Cited by 9 publications

References 3 publications

Esophageal pulmonary fistula – a rare complication of radiation therapy: a case report

Esophageal pulmonary fistula – a rare complication of radiation therapy: a case report

Thoracic Complications of Oesophageal Carcinoma- A Retrospective Analysis of Ct Appearances

A rare cause of esophagopleural fistula due to intensity-modulated proton therapy: a case report and review of literature

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