Multiple esophagogastric fistulas resulting from reflux esophagitis

A case of multiple esophagogastric fistulas is reported along with the endoscopic and radiological findings. The literature is reviewed. There is only one other case report of multiple, isolated esophagogastric fistulas described by Mullen, et al (1975). In that individual the etiologic factor was previous esophageal surgery for stricture. In the patient reported here, the long history of reflux symptoms and endoscopic and biopsy findings strongly suggest a causal relationship. Fistula formation may be an additional complication of prolonged gastroesophageal reflux.