Congenital tracheoesophageal fistula in an elderly patient with thoracic empyema.

A congenital tracheoesophageal fistula is rare in elderly patients. An adult case of congenital tracheoesophageal fistula complicated with thoracic empyema was successfully treated by surgery. A 74-year-old woman was admitted with severe coughing and fever. The patient had experienced several episodes of pneumonia since childhood. Chest radiography showed left pleural effusion; and fiberoptic bronchoscopy and chest computed tomography demonstrated a tracheoesophageal fistula communicating between the upper intrathoracic esophagus and the distal portion of the trachea. Following tube drainage of the left thoracic empyema, transection of the fistula was performed. The postoperative course was uneventful, and she is doing well at 1 year after surgery without recurrence of the symptoms.