[An adult case of congenital esophagobronchial fistula accompanied with bronchial branch of the vagal nerve].

A case of congenital esophagobronchial fistula in a 73-year-old woman was described. The patient had presented with repeated attacks of pulmonary infection from her childhood and had a several years history of recurrent cough after eating or drinking. Preoperative examinations including esophagogram by barium swallow revealed existence of a fistula between middle thoracic esophagus and right B6 bronchus. The fistula was recognized as Type II of Braimbridge and Keith's classification. The fistula was surgically removed with the atelectatic right lower lobe. Neither adhesion nor enlargement of lymph nodes was found in the surrounding tissues. Because the bronchial branch of vagus was found along the fistula, this lesion was strongly suggested of congenital origin. Histological observations of the resected fistula showed no chronic inflammatory changes, though muscular layers and transitional zone between squamous epithelium and bronchial epithelium were present. The differential diagnosis between the congenital and acquired types is sometimes very difficult. The existence of the bronchial branch of vagus along the fistula means that the fistula is a congenital type, definitely.