Herpetic bronchitis with a broncho-oesophageal fistula.

Tracheobronchitis and oesophagitis due to herpes simplex virus (HSV) are rare. Tracheo-oesophageal fistula due to HSV oesophagitis has been described in the immunocompromised host. A case is reported of a broncho-oesophageal fistula which developed secondary to herpetic bronchitis in an apparently immunocompetent patient.     

Congenital tracheoesophageal fistula in the adult

Congenital tracheoesophageal fistula can persist and remain undetected until adulthood. We have recently encountered such a case and reviewed the others reported in the English literature. Commonly, symptoms are present during infancy, but an occasional patient develops symptoms only later in life. Diagnostic confirmation may be quite difficult, and the esophagogram appears to be the most reliable test. Chronic pulmonary suppuration is unusual, and most tracheoesophageal fistulas may be satisfactorily repaired by way of a cervical approach.     

Congenital tracheo-oesophageal fistula in the adult

A case of congenital tracheo-oesophageal fistula without oesophageal atresia in an adult is presented. Surgical repair via a right thoracotomy was successfully undertaken. The 13 previously reported cases in English publications are reviewed.     

Congenital broncho-esophageal fistula in the adult

The case of a 62-year-old woman with a type II congenital broncho-esophageal fistula is presented. She had had recurrent pulmonary infections that were more prominent in the last 15 years. A barium swallow examination showed a communication between the esophagus and the right lower lobe. High resolution computed tomographic scan of the chest revealed right middle and lower lobe bronchiectasis. Bronchoscopy was unremarkable. At thoracotomy bronchoesophageal fistula was divided and the esophageal end was repaired in two layered fashion and reinforced by pediculed parietal pleural flap. Right middle and lower lobectomies were performed. Demonstration of the broncho-esophageal fistula and assessment of the status of the pulmonary parenchyma are important steps prior to surgery.     

Congenital bronchoesophageal fistula in the adult

Congenital bronchoesophageal fistulas, when not associated with esophageal atresia, are compatible with life and may persist until adulthood before diagnosis has been established. We report such a rare case of a 55-year-old Caucasian female with a history of repeated pulmonary infections, suffering from cough during the last 12 months due to a mass in the right lung. A bronchoesophageal fistula (type III according to Braimbridge and Keith classification) was incidentally discovered during thoracotomy which was resected and end-sutured. Following that, a right lower lobectomy was performed. The patient had an uneventful recovery. The final diagnosis of congenital bronchoesophageal fistula was established excluding all the reasons that lead to the acquired disease. The diagnostic and therapeutic procedures are analyzed and the relevant literature is reviewed.     

Congenital tracheo-oesophageal fistula in a young adult.

Congenital tracheo-oesophageal fistula (TEF) is rare in adults. Patients who present with repeated attacks of chest infection since birth or cough, choking and cyanosis during feeding should be investigated for TEF. It should be possible to detect all cases of tracheo-oesophageal fistulae using bronchoscopy, oesophagoscopy and CT either singly or in combination. These investigations also help in deciding on the route of exploration and the type of surgery. Disconnection of the abnormal fistulous tract brings dramatic relief of symptom and prevents further pulmonary damage.     

Congenital esophagobronchial fistula in an adult

Congenital esophagobronchial fistula occurring in infancy and childhood is a well-recognized entity necessitating urgent surgical treatment. Persistence of such a communication into adulthood is rare and would seem possible only if the tract were small so that aspiration into the lung could be tolerated. The case of a 38-year-old woman is presented in this report who was cured of lifelong symptoms of aspiration by surgical division of a presumed congenital esophagobronchial fistula.     

Congenital bronchobiliary fistula: first case in an adult.

The first adult case of a congenital communication between the biliary tract and the right main bronchus is reported. Treatment by surgical excision and pneumonectomy was successful.     

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

The treatment of benign broncho-oesophageal fistula is usually surgical but sometimes other methods of treatment are preferred. The case history is described of an adult in poor general condition in which an endoscopic approach combined with the use of fibrin glue on the bronchial side and metallic clips on the oesophageal side was used to close the fistula.     

Congenital oesophagobronchial fistula in an adult involving left main bronchus.

Congenital fistulae between the tracheobronchial tree and oesophagus usually originate from the lower end of the trachea or right main bronchus. The case history is presented of a man in whom a fistula between the oesophagus and left main bronchus was not diagnosed until the age of 48.