A Case of Congenital Esophago-Bronchial Fistula with Diverticulum in the Adult

Yutaka Kuroda, Hiroshi Hongo, Hidenori Sakai, Satoru Kurata, Kiyoshi Nakayasu, Toshiaki Kamei*

Department of Surgery, Prefectural Yamaguchi Central Hospital and *Department ofPathology, Prefectural Yamaguchi Central Hospital

A case of congenital esophago-bronchial fistula with an esophageal diverticulum in a 27-year-old female is presented. The patient, a pharmacist, was referred to the Yamaguchi Central Hospital in April 1988, complaining of paroxysmal coughing after liquid ingestion which she had suffered from for about 14 years. A barium swallow showed a fistulous tract between the esophagus and the right lower lobe bronchus (B7). Esophagoscopic examination revealed that a diverticulum with a round opening was present in the middle thoracic esophagus (25) cm from the incisors). Bronchial mucosa was seen through the opening. An endoscopic biopsy specimen from the fistula consisted of ciliated columnar epithelium. On May 20th, 1988, she was treated by right thoracotomy and complete removal of the fistulous tract and the diverticulum. The esophago-bronchial fistula was 3 cm in length and 1 cm in diameter, without adhesion to the surrounding structures. There was no lymph node swelling around the fistula. The resected specimen was free from inflammatory change such as lympocyte infiltration and fibrosis. A transitional zone from squamous epithelium to ciliated epithelium was not demonstrated microscopically, but mucosal transition was thought to be present from endoscopic examination and finding of biopsy. Hence, this case was categorized as Braimbridge type I esophago-bronchial fistula.

Key words
congenital esophago-bronchial fistula, esophageal diverticulum, Braimbridge type I

Reprint requests
Yutaka Kuroda Department of Surgery, Prefectural Yamaguchi Central Hospital
77 Oosaki, Houfu, 747 JAPAN

Accepted
March 7, 1990

To read the PDF file you will need Abobe Reader installed on your computer.