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Benign esophagorespiratory fistulas in adults
R E Vasquez1, M Landay, W J Kilman
1Department of Radiology, University of Texas Southwestern Medical Center, Dallas 75235.
Radiology
|April 1, 1988
Summary
Benign esophagorespiratory fistulas are rare, often presenting as recurrent lung infections. Prompt diagnosis with imaging and treatment with antibiotics and surgery leads to good outcomes.
Area of Science:
- Medicine
- Pulmonology
- Gastroenterology
Background:
- Esophagorespiratory fistulas are rare abnormal connections between the esophagus and the respiratory tract.
- They can be congenital or acquired, often leading to recurrent pulmonary complications.
Purpose of the Study:
- To report on the diagnosis and management of four adult patients with benign esophagorespiratory fistulas.
- To highlight the clinical presentation and diagnostic imaging findings.
Main Methods:
- Review of four adult cases diagnosed with benign esophagorespiratory fistulas over one year.
- Analysis of clinical symptoms, chest radiography findings, and barium study results.
- Evaluation of treatment response to antibiotics and surgery.
Main Results:
- Three cases were secondary to granulomatous disease; one was presumed congenital.
- Common symptoms included chronic/recurrent pulmonary infections and post-swallowing coughing.
- Chest radiographs showed persistent consolidation, sometimes with cavitation and air-distended esophagus.
- Barium studies were diagnostic for all patients.
Conclusions:
- Benign esophagorespiratory fistulas can present insidiously with pulmonary symptoms.
- A high index of suspicion and appropriate imaging are crucial for diagnosis.
- Combined antibiotic and surgical therapy is effective for managing these fistulas.