Esophagobronchial Fistula Resulting from Esophageal Intramural Pseudodiverticulosis

Abstract

Diffuse, intramural esophageal pseudodiverticulosis is a rare condition manifested by progressive or intermittent dysphagia. Although much controversy has arisen regarding its etiology, it is believed to be a result of the dilatation of excretory ducts of submucosal glands within the esophageal wall. The characteristic appearance on barium studies and its unique pattern on endoscopy simplify its recognition. Treatment usually centers around symptomatic relief with esophageal dilatations. Complications arising from this disorder generally are related to the dysphagia and its sequelae. Esophagobronchial fistulization has not been reported in the literature in association with intramural pseudodiverticulosis. We present a case that characterizes the salient features of this disease along with the development of an esophagobronchial communication resulting in recurrent bouts of pneumonia.

Esophageal Intramural Pseudodiverticulosis and Esophagobronchial Fistula Palliated with Esophageal and Bronchial Stenting: A Rare Case Report

“…6 A single previously reported case of EIP similarly complicated by EBF exists in the literature. 7 In that case the patient was treated with a McKeown esophagectomy. EBF typically presents with cough induced by swallowing and recurrent bouts of aspiration pneumonia localized to the communicating lobe of the lung.…”

Complex oesophageal disease in a 72‐year‐old male

“…Some patients are asymptomatic with the condition being identified incidentally in around 20% of cases . Presentation with fistula formation or mediastinitis has been described, although this is very rare . The main management principles are to treat the underlying pathological cause and to manage any complications .…”

“…2,8 Presentation with fistula formation or mediastinitis has been described, although this is very rare. [8][9][10] The main management principles are to treat the underlying pathological cause and to manage any complications. 4 This could include antifungals and treatment of reflux disease (including operative management).…”