[A case report--congenital esophago-bronchial fistula with esophageal diverticulum]

Congenital esophago-bronchial fistula with diverticulum is rare, and in Japan only 29 cases have been reported. A 59-year-old man had suffered from recurrent pulmonary infections and often complained of coughing while drinking water during the previous two years. An UGI series for follow-up of gastric ulcer revealed an esophago-bronchial fistula, located between the mid-esophagus and B10 of the right lung. We resected the diverticulum and the fistulous tract with a partial excision of S10. Histological examination revealed that the squamous epithelium with the muscularis mucosa of the esophagus was smoothly connected to the columnar epithelium of the bronchus. Thus, we diagnosed this fistula as congenital, not acquired. Comparison of the previous UGI series before presenting symptoms with that performed at this admission showed the lengthening and thickening of this congenital fistula during the three-years period. We suspected that the influence of acquired factors may cause a congenital fistula to manifest various clinical symptoms.