Abstract
An infected cause of esophagobronchial fistula between left bronchus and esophagus is mentioned who is a 32 year old male with a history of smoking and I/V drug abuse. The scientific reasons for suspecting an esophagogastric-bronchial fistula in an adult are discussed, as well as a description of the different etiologies of this condition. Intra thoracic malignancy, injuries, and infections are the most frequent causes of esophageal-bronchial fistula. These fistulas are caused by the rupturing of caseous peribronchial lymph nodes into adjacent structures such as the esophagus and bronchi. It's difficult to determine what the right course of action is. Such cases are surgically treated, while others can only be treated conservatively. Diagnosing bronchoesophageal fisula is usually challenging and often delayed, since there have not been many cases found. Any patient who presents with cough after deglutition should be suspected of having an esophagobronchial fistula, and tubercular origin should also be considered, particularly in an endemic region, since early diagnosis and treatment with anti-tubercular therapy typically results in resolution.
Highlights
The most common cause of esophagobronchial fistula is intra thoracic malignancy followed by trauma and infections
Despite their more frequent appearance, acquired esophagobronchial fistulas have gained less recognition in the recent medical literature than congenital communications between the esophagus and the respiratory tree. This is unquestionably due to the fact that the vast majority of acquired fistulas are a late and terminal symptom of an underlying malignant phase, most often esophageal carcinoma
Due to the absence of clear signs or symptoms, BEF diagnosis is generally difficult and sometimes delayed. These fistulae have been related to the presence of tuberculous mediastinal adenopathy, which induces necrosis and perforation of the adjacent structures, providing the conditions for fistula formation [8], [15], [16]
Summary
The most common cause of esophagobronchial fistula is intra thoracic malignancy followed by trauma and infections. Despite their more frequent appearance, acquired esophagobronchial fistulas have gained less recognition in the recent medical literature than congenital communications between the esophagus and the respiratory tree. Many of the cases historically known as "indeterminate aetiology" may fall into this category Those of infective cause are mostly because of granulomatous inflammation of mediastinal lymph nodes. Following this an oral gastrograffin contrast X-ray was done which showed a fistula (Fig. 2) between the left main bronchus and esophagus. After 4 months of treatment the patients cough improved and repeat endoscopy showed resolution of the ulcers and the fistula. He completed 6 months treatment and made an uneventful recovery
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