[Esophago-bronchial fistula].

Tuberkuloza

Published: February 1966

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We report a case of unresectable advanced esophageal cancer with an esophageal fistula that was treated with pembrolizumab plus CDDP plus 5-FU therapy and the fistula was closed. A 73-year-old male was diagnosed with cervical-upper thoracic esophageal cancer and esophago-bronchial fistula on CT and esophagogastroduodenoscopy. He underwent chemotherapy containing pembrolizumab.

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An acquired esophago-respiratory fistula represents an abnormal connection between the esophagus and the respiratory system. It is usually caused by malignancy and infection, or it occurs as a complication after surgery or radiation therapy. It can be divided according to its anatomical level into esophago-tracheal fistula, esophago-bronchial fistula, and in the rarest case, esophago-pulmonary fistula (EPF).

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Article Synopsis
  • The development of an esophago-bronchial fistula is a rare but serious complication following esophagectomy, leading to high mortality rates.
  • A 63-year-old man experienced this complication after surgery for esophageal cancer, facing respiratory failure due to severe reflux and ischemia at the surgical site.
  • A novel three-step surgical approach was successfully implemented to address the fistula and restore esophageal function, demonstrating potential for patients unable to undergo traditional surgical interventions.
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Acquired esophago-respiratory fistulae are usually esophago-tracheal or esophago-bronchial. Esophago-pulmonary fistulae are rare. Most patients present with cardinal symptoms of esophageal carcinoma or esophago-pulmonary fistula leading to early diagnosis.

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Rationale: An esophago-bronchial fistula is one of the rare postoperative complications of esophageal cancer. There are various medical treatments, including suturing, endoscopic clip, and fibrin glue. However, these treatments often lead to unsatisfactory results, causing physicians to opt for surgical alternatives.

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