Gastric tube-to-pleural fistula seventeen months after esophagectomy

A gastric tube-to-pleural fistula is an uncommon late complication of esophagectomy. In this report, a 71-year-old man who developed gastric tube-to-pleural fistula 17 months after esophagectomy with intrathoracic reconstruction using a gastric tube is presented. Chest radiograph on admission showed massive right pleural effusion, which demonstrated empyema on chest drainage. Further imaging studies confirmed a gastric tube-to-pleural fistula that had no connection to the airway. We chose endoscopic intervention as a less invasive procedure and successfully treated the patient by plugging fibrin glue into the fistula under endoscopy. Review of the literature and discussion of the clinical features, differential causes, and treatment options of this rare and severe condition are presented.