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


METHODS
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.


CONCLUSIONS
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.
Department of Cardiothoracic surgery, South Manchester University Hospital, NHS Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK. mohandev@hotmail.com
Mohan P
MP
Devbhandari
Rohit
R
Jain
Simon
S
Galloway
Piotr
P
Krysiak
D001983:Bronchial Fistula / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D003951:Diagnostic Errors; D016629:Esophagectomy; D005747:Gastric Fistula / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000601:surgery