Broncho-gastric fistula complicating transthoracic esophagectomy

Tracheo-esophageal and broncho-esophageal fistulas are recognized complications in advanced esophageal cancers. The common complications seen after transthoracic esophagectomy include pulmonary complications, anastomotic leaks, gastric stasis, and anastomotic strictures. A broncho-gastric fistula is a very rare complication of transthoracic esophagectomy and has been reported anecdotally in the literature. We report a patient who underwent a transthoracic esophagectomy and developed a broncho-gastric fistula caused by a staple from the stomach tube suture line eroding into the right bronchus. Diagnosis was made by fiberoptic bronchoscopy. The patient was successfully treated with re-exploratory thoracotomy and closure of the fistula.