Case report

Benign gastro-bronchial fistula – an uncommon complication of esophagectomy: case report

Mohan P Devbhandari¹ , Rohit Jain¹ , Simon Galloway² and Piotr Krysiak¹

¹  Department of Cardiothoracic surgery South Manchester University Hospital, NHS Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK

²  Department of General Surgery South Manchester University Hospital, NHS Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK

author email corresponding author email

BMC Surgery 2005, 5:16doi:10.1186/1471-2482-5-16

Published:	30 June 2005

Abstract

Background

Gastro-bronchial fistula (GBF) is a rare and devastating complication following esophagectomy. Making the correct diagnosis is difficult and there is no agreement on the treatment for this rare condition.

Case presentation

We report the case of a 56-year-old man who presented with features of repeated aspiration and chest infections six years following an esophagectomy for Barrett's esophagus. Despite extensive investigations the cause of symptoms was difficult to determine. The correct diagnosis of fistula from stomach to right main stem bronchus was made at bronchoscopy under general anesthesia. After ruling out local recurrence of cancer, a successful primary repair was carried out by resection of fistula and direct repair of gastric conduit and bronchus. He is well after 6 months of treatment.

Conclusion

Late development of gastro-bronchial fistula is a rare complication of esophageal resection that may be difficult to diagnose.

Surgical resection and direct closure is the treatment of choice, although the method of treatment should be tailored according to the anatomy of the fistula and the patient's condition.