Westhoff M, Litterst P, Al-Shahrabani F
Klinik für Pneumologie, Hemer.
Pneumologie. 2012 Feb;66(2):74-7. doi: 10.1055/s-0031-1286633. Epub 2011 Nov 2.
Broncho-oesophageal fistulas in broncholithiasis are extremely rare. Preceding lithoptysis is only seen infrequently. We report on a 68-year-old patient who complained of cough for more than 3 years. 5 months prior to admission he had hemoptysis and expectorated several greyish stones of up to 5 mm diameter. Endoscopy revealed a small excavation at the medial wall of the left main bronchus. Compared to a former CT, an actual CT scan of the thorax showed a small fistula between the oesophagus and the left main bronchus and revealed a missing calcification at this site. The patient underwent a left-sided thoracotomy with excision of the fistula, suture of the oesophagus and interponation of a flap of the M. latissimus dorsi. The demonstration of broncholith migration with CT scans before and after lithoptysis, the development of a left-sided fistula and its demonstration in the CT scan as well as endoscopically have not been reported in this combination before.
支气管结石症中的支气管食管瘘极为罕见。咯血前的咯石现象也很少见。我们报告一例68岁患者，主诉咳嗽3年多。入院前5个月，他出现咯血，并咳出数颗直径达5毫米的灰白色结石。内镜检查发现左主支气管内侧壁有一个小溃疡。与之前的CT相比，此次胸部CT扫描显示食管与左主支气管之间有一个小瘘管，且该部位钙化消失。患者接受了左侧开胸手术，切除瘘管，缝合食管，并植入背阔肌瓣。咯血前后CT扫描显示支气管结石移位、左侧瘘管形成及其在CT扫描和内镜下的表现，此前尚未有这种综合报道。
