An incidentally diagnosed bronchoesophageal fistula in an adult

Abstract

Dogustan bronkoozofageal fistuller (BEF) genellikle yenidogan doneminde tespit edilir. Sadece basit tip (tip 2) fistuller eriskin caga kadar tani konulmadan kalabilir. Dogustan BEF’ler, fistul agzinin membran ile kapali oldugunda ya da bronsiyal orifis seviyesi ozofageal orifisin uzerinde olmasi gibi durumlarda uzun zaman gizli kalabilir. Bronkoozofageal fistuller tani konulduktan sonra derhal cerrahi girisim ile tedavi edilmelidir. Dogustan BEF’ler, iyi huylu olsalar da masif hemoptizi gibi hayati tehdit eden komplikasyonlara da yol acabilirler. Bu yazida 55 yasinda, dogustan bronkoozofageal fistulu olan bir kadin hasta sunuldu. Bronkoozofageal fistul suphesi, ilk kez kasik fitigi ameliyati sirasinda gelisti. Hastanin onceden hafif olan semptomlari tanisal islemler sonrasinda kotulesmeye basladi. Daha sonra sag torakotomi ile fistulektomi ve sag alt lobektomi ameliyati yapildi. Anah tar soz cuk ler: Bronkoozefageal fistul; hemoptizi; lobektomi; torakotomi. Congenital bronchoesophageal fistulas (BEFs) are usually diagnosed during the neonatal period. Only simple types (type 2) may remain undiagnosed until adulthood. Congenital BEFs may remain hidden if the orifice of the fistula is closed with a permanent membrane, and/or the esophageal orifice is below the level of the bronchial orifice. Bronchoesophageal fistulas should be treated as soon as the diagnosis is confirmed with early surgical intervention. Despite their benign nature, congenital BEFs may lead to fatal complications, for example massive hemoptysis. In this article, we present a 55-year-old female patient with a congenital BEF. The fistula was first suspected during an inguinal hernia operation. Her mild symptoms became worse following the diagnosis, and hemoptysis developed. A fistulectomy using a right thoracotomy and right lower lobectomy were then performed.