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Congenital broncho-oesophageal fistula in the adult
Insights
This case report details a congenital broncho-oesophageal fistula in an adult, successfully treated with surgery. The findings suggest a refined classification for these rare fistulae based on anatomical and clinical factors.
Area of Science:
- Medical Case Report
- Thoracic Surgery
- Gastroenterology
Background:
- Congenital broncho-oesophageal fistulae are rare anomalies.
- Symptoms often include recurrent respiratory infections and gastrointestinal issues.
Observation:
- A 46-year-old male presented with a history of childhood chest infections, heartburn, and flatulence.
- Diagnostic imaging revealed a broncho-oesophageal fistula connecting the left lower lobe bronchi to the oesophagus, alongside a hiatal hernia and diverticulum.
Findings:
- Surgical resection of the fistula and left lower lobectomy were performed.
- The patient experienced an uneventful recovery post-surgery.
- Review of 20 published cases informed a proposed classification system.
Implications:
- The proposed classification emphasizes fistula type, communicating bronchus, symptom onset age, and duration.
- Accurate classification is crucial for understanding and managing congenital broncho-oesophageal fistulae.
- This case highlights the importance of considering congenital anomalies in adult patients with persistent respiratory and digestive symptoms.
Abstract:
The case of a 46-year-old man with congenital broncho-oesophageal fistula is presented. The patient had had recurrent chest infections since childhood and a recent history of heartburn and flatulence. A barium-swallow examination showed a small sliding hiatal hernia and an oesophageal diverticulum communicating via a fistula with the apical and posterior segmental bronchi of the left lower lobe. Bronchography showed bronchiectasis in this lobe. At thoracotomy resection of the broncho-oesophageal fistula and left lower lobectomy were performed. The patient's recovery was uneventful. Twenty published cases are reviewed. The classification of congenital broncho-oesophageal fistulae should take account not only of the type of fistula but also of the type and size of the bronchus with which the fistula communicates, the age of the patient at the first appearance of symptoms, and the duration of symptoms.