A Case of Colobronchial Fistula 14 Years after Total Gastrectomy

Kenichi Oyama, Akinori Takagane, Miyuki Sone¹⁾, Kenichi Kato¹⁾, Shuuji Kawamura²⁾, Chihiro Tono²⁾ and Kazuyoshi Saito

Department of Surgery 1 and Department of Radiology¹⁾, Iwate Medical University
Department of Surgery, Iwate Prefectural Esashi Hospital²⁾

A 70-year-old man undergoing total gastrectomy for gastric cancer in August 1998 and subsequent reoperation for anastomotic leakage was delay in recovery by a left subphrenic abscess resolved by conservative management. Fourteen years later, he was admitted for incurable interstitial pneumonia. A barium-enema study showed barium passing via the splenic flexure into the bronchi of the left lower lobe but no evidence of colonic malignancy and inflammatory bowel disease, so the colobronchial fistula was attributed to subphrenic abscess as a complication of his last surgery. Because a severe adhesion in his abdominal cavity was expected, not a radical operation but a temporizing operation, colostomy and bronchial embolization were performed. The bronchial fistula was occluded by placing steel coils introduced through an angiographic catheter. His clinical course improved markedly thereafter and he was discharged on postoperative day 23. We report this rare case of colobronchial fistula with a review of the literature.

Key words
colobronchial fistula, subphrenic abscess, bronchial embolization

Reprint requests
Kenichi Oyama Department of Surgery 1, Iwate Medical University
19-1 Uchimaru, Morioka, 020-8505 JAPAN

Accepted
January 26, 2005

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