Congenital Esophagobronchial Fistula Complicated with Pneumonia after Cholecystectomy: Report of A Case

Kenichiro Fukuhara, Harushi Osugi, Kiyotoshi Inoue, Nobuyasu Takada, Masashi Takemura, Toshihiko Kato, Hiroshi Kato, Takashi Iwata, Tatsuya Nishida and Hiroaki Kinoshita

Second Department of Surgery, Osaka City University, Medical School

An adult case of congenital esophagobronchial fistula is reported. A 56-year-old man known to have diverticulum in the midesophagus, was refurred to us for evaluation of pneumonia of the left lower lobe which developed after open cholecystectomy. Careful endoscopic observation revealed tiny orifices in the bottom of the diverticulum, and fistulography showed connection between the orifices and the left lower lobe bronchus. On the 115 th day after cholecystectomy, the esophageal diverticulum and the fistula were removed together with the carnified left lower lobe through a left thoracotomy. Recovery has been uneventful with no respiratory infection. The condition was diagnosed as congenital esophagobronchial fistula because the direct communication between the esophageal epithelium with muscular mucosa and the bronchial epithelium was confirmed histologically and was classified as Braimbridge type I since the fistula orifice was in the esophageal diverticulum. Congenital esophagobronchial fistula manifesting in adulthood is rare, and 45% are Braimbridge type I. Careful endoscopic observation of the esophageal diverticulum and consideration of congenital esophagobronchial fistula may avoid unnecessary aspiration pneumonia.

Key words
congenital esophagobronchial fistula, Braimbridge type I, surgical treatment

Reprint requests
Kenichiro Fukuhara Second Department of Surgery, Osaka City University, Medical School 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585 JAPAN

Accepted
September 22, 1999

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