Colobronchial fistula following a partial resection of the colon

Marina Maras–Šimunić ,Nikola Kolja Poljak ,Dragan Dragičević ,Maja Škorić ,Marin Šimunić

doi:10.22514/sv82.102013.14

Abstract

We report a case of colobronchial fistula as a late consequence of the resection of the colon due to relapse of the gastro-intestinal stromal tumor (GIST). A 54-year-old man experiencing pain in the left upper abdominal region underwent double-contrast barium enema which revealed a fistulous channel between the splenic flexure of the colon and the bronchial tree. Fiberoptic bronchoscopy, after an extensive washout and aspiration of barium sulphate, confirmed the existence of a fistula in left lower subsegmental bronchi. The patient underwent left lower lobectomy, resection of the colobronchial fistula and resection of the splenic flexure of the colon. A year after the operation, the multidetector computed tomography (MDCT) showed neither signs of malignant abdominal disease, nor signs of pathological changes in the lung bases.

Highlights

A fistula located between the colon and the bronchial tree is very rare
In the case of our patient, the fistula channel has been formed as a consequence of a partial resection of the splenic flexure of the colon with lateroterminal anastomosis, due to a relapse of the stomach gastrointestinal stromal tumor (GIST) in the left subphrenic region
There are a few reports in literature which connect surgery and colobronchial fistulas as a complication following coloesophageal interposition, [5] total gastrectomy, [7] or laparoscopic cholecystectomy

Summary

Introduction

A fistula located between the colon and the bronchial tree is very rare. [1] Some cases of colobronchial fistulas are reported as a consequence of trauma, [2] infections, [3] and malignant neoplasm. [4] Postoperative colobronchial fistula is exceptional, described in the literature as a complication of the coloesophageal interposition [5] and of splenectomy, partial gastrectomy and distal pancreatectomy. [6] Colobronchial fistula is usually present as recurrent pneumonia, and is very difficult to diagnose, almost never after the onset of respiratory symptoms. In this paper we describe a case of colobronchial fistula as a late consequence of the surgery of malignant neoplasm of the colon

Case presentation

Discussion