Endoscopic occlusion of idiopathic benign esophago-bronchial fistula

We report a 35-year-old male with recurrent respiratory infections and cough associated with ingestion of food for 15 years. He was diagnosed to have benign esophago-bronchial fistula and proximal jejunal stricture secondary to a tumor, which was surgically resected. In view of recent surgery, endoscopic closure of the fistula was attempted initially with an endoclip resulting in partial symptomatic relief. The fistula was later completely occluded endoscopically with cyanoacrylate glue. A barium swallow at eight-months follow-up revealed no evidence of esophago-bronchial communication. A high index of suspicion is required in the diagnosis of this rare entity in adults with recurrent respiratory infections of obscure etiology. Surgical resection is the standard treatment. Here we report a rare case of idiopathic benign esophago-bronchial fistula in an adult, treated with endoscopic approach.