Aspiration Via Congenital Broncho-esophageal Fistula After Lobectomy

Abstract

Aspiration via a congenital broncho-esophageal fistula in an adult thoracotomy patient has not been previously reported. Repeated aspiration and subsequent respiratory failure if the fistula is not recognized could be life-threatening in these postoperative patients. We describe one such critical case, in which a broncho-esophageal fistula was discovered weeks after aspiration and the onset of respiratory failure after left lower lobectomy. This unusual case suggests that repeated localized pulmonary infections can indicate a broncho-esophageal fistula and that further investigations should be performed, including detailed history.

Adult Benign, Non‐Iatrogenic Bronchoesophageal Fistulae: Systematic Review and Descriptive Analysis of Individual Patient Data

“…A shorter duration of symptoms, a greater need for enteral feeding, higher morbidity, failure and recurrence rates suggest that patients affected by BEFs of infective origin tend to have a more severe clinical picture compared to BEFs of congenital origin (Table 4). Surgery is the main modality of definitive treatment for congenital BEF, with very few exceptions [24, 25]. On the other hand, for patients with infective BEFs, healing by medical therapy and enteral nutrition alone is reported in a consistent proportion of patients (Table 4).…”