A Case of Esophagobronchial Fistula Effectively Treated with Cyanoacrylate

Yu Takagi, Sigeru Sato, Naoki Kuroda, Yosiaki Osaka, Makoto Takagi, Mikiya Hayasi, Kazuhiko Tamura, Ryosuke Okada, Tatuya Aoki and Yasuhisa Koyanagi

Department of Surgery, Tokyo Medical College

Esophagobronchial fistulas have been treated conservatively, endoscopically, or surgically. We report a case of endoscopic closure of a fistula using ethyl-2-cyanoacrylate (ECA) which is a bioadhesive prodruct, obtaining good result. A 73-year-old man suffered from chest disconfort in early June 1997. On June 6, endscopic examaination revealed a diverticululm 32-cm away from the superior incisor teeth at the 3 o'clock position associated with a 2-mm fistula in it. On July 2, radiographic examination of the fistula disclosed leakage of contrast medium from the right B6. On July 10, 1ml of ECA was applied with a spraying tube, followed by contrast studies to confirm the closure of the fistula. Contrast study 4 days after the spraying showed minor leakage of contrast material, so application of 1ml ECA was repeated. The next day the patient started ingesting food and was discharged from the hospital with an uneventful course. Endoscopic closure of a fistula is thought to be an effective treatment for patients before consideration of surgery and those with a poor general condition due to its relative simplicity and safe repeatability.

Key words
esophagobronchial fistula, cyanoacrylate, fibrin glue

Reprint requests
Yu Takagi Department of Surgery, Tokyo Medical College 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023 JAPAN

Accepted
November 13, 1998

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