Benign bronchoesophageal fistula: Report of four cases

Abstract

enign bronchoesophageal fistula (BEF) is rare and may be characterized by nonspecific symptoms that may delay a correct diagnosis. 1 As soon the diagnosis of BEF is made, immediate surgical treatment is necessary to avoid complications. We present 4 cases of benign BEF that we encountered over a 20-year period.

Benign Bronchoesophageal Fistula in Adults: Endoscopic Closure as Primary Treatment

“…6 Once a BEF is confirmed, early surgical intervention is considered definitive, resulting in successful outcomes. Although early and definitive surgical repair has yielded promising results, 5,6,15 the in-hospital mortality rate has been reported to be as high as 15.4%, 3 and the surgery itself is invasive. This has led to the development of endoscopic and even medical treatment methods.…”

“…Fistulas may also be due to benign causes, including infections, such as tuberculosis and histoplasmosis, trauma, and other causes. [1][2][3][4][5] Owing to their nonspecific symptoms and rarity, however, benign BEF may be present for a long time without being diagnosed and properly treated, resulting in significant morbidity and death.…”

Combined endoscopic approach in the treatment of benign broncho-oesophageal fistula

“…The diagnosis may be made by endoscopic examination of the bronchi and oesophagus which may show a papilla or a dimple, or by oesophagography with dilute barium showing the contrast entering the bronchi 1. Sometimes, despite extensive investigation, the correct diagnosis is made only at surgery.…”

“…In adults BEFs are usually acquired as it is rare for a congenital BEF to go undetected until adulthood, and they can be the result of malignant or benign processes. The latter can be of traumatic, inflammatory, infective or iatrogenic origin 1. The non-specific nature of the presenting symptoms may delay a correct diagnosis, and patients are often first seen for pulmonary infections 1.…”

“…The latter can be of traumatic, inflammatory, infective or iatrogenic origin 1. The non-specific nature of the presenting symptoms may delay a correct diagnosis, and patients are often first seen for pulmonary infections 1. Surgery is usually the preferred treatment but in some cases—for example, in patients in a poor clinical condition—other approaches have been described.…”