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Ann Thorac Surg 2007;84:1036-1038
© 2007 The Society of Thoracic Surgeons

Case Reports

Successful Conservative Management of Benign Gastro-Bronchial Fistula After Intrathoracic Esophagogastrostomy

Davide Bona, MDa, Dario Sarli, MDa, Greta Saino, MDa, Matteo Quarenghi, MDb, Luigi Bonavina, MDa,*

a Department of Medical and Surgical Sciences, Division of General Surgery, I.R.C.C.S. Policlinico San Donato, University of Milan, Milan, Italy
b Division of Radiology Unit, I.R.C.C.S. Policlinico San Donato, University of Milan, Milan, Italy

Accepted for publication April 13, 2007.

* Address correspondence to Prof Bonavina, U.O. Chirurgia Generale, Policlinico San Donato, Via Morandi 30, San Donato Milanese, Milan, 20097, Italy (Email: luigi.bonavina{at}unimi.it).

Benign gastro-bronchial fistula is a rare and devastating complication of esophagectomy with gastric replacement. The most likely cause is a leak from the esophagogastric anastomosis with subsequent mediastinal abscess and rupture into the posterior wall of the tracheobronchial tree. The clinical presentation includes cough upon swallowing, fever, and recurrent pneumonia. Early surgical treatment is the standard of care. A unique case of chronic gastro-bronchial fistula is reported in this article. The patient, a 57-year-old woman, was referred from another hospital after 6 months of symptomatic therapy and total enteral nutrition. A self-expanding esophageal metal stent allowed exclusion of the fistula with symptom relief and return to oral alimentation.






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Copyright © 2007 by The Society of Thoracic Surgeons.