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一例成人先天性支气管食管瘘的罕见病例。

A rare case of congenital bronchoesophageal fistula in an adult.

作者信息

Taira Naohiro, Kawasaki Hidenori, Atsumi Eriko, Furugen Tomonori, Ichi Takaharu, Kushi Kazuaki, Yohena Tomofumi, Baba Motoo, Kawabata Tsutomu

机构信息

Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan.

Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan.

出版信息

Int J Surg Case Rep. 2017;36:182-184. doi: 10.1016/j.ijscr.2017.03.029. Epub 2017 Mar 21.

Abstract

INTRODUCTION

When congenital bronchoesophageal fistulas exist without atresia of the esophagus, the diagnosis can be delayed, although symptoms may occur early following fistula development. Therefore, while they are usually found in infants, they can be extremely rarely found in adults. We herein report a rare case of bronchoesophageal fistula without atresia in an adult.

CASE

An 69-year-old male presented to the outpatient clinic with a decades-long history of cough with expectoration immediately after taking food, especially liquids. Computed tomograph, esophagoscopy, and esophagography revealed the fistulous communication between the mid-esophagus and right lower lobe bronchus, with consolidation in the right lower lobe. We performed right lower lobectomy with the closure and excision of the fistula. The histopathology of the fistula revealed the mucosa to be lined by stratified squamous epithelium. There was no evidence of inflammation, granuloma, or carcinoma.

CONCLUSION

In conclusion, despite the benign nature of this malformation, if left untreated, it can cause long-term debilitating respiratory symptoms associated with the fistula. Therefore, the diagnosis should be considered in the evaluation of recurrent lung infection.

摘要

引言

当先天性支气管食管瘘存在而食管无闭锁时,尽管瘘形成后早期可能出现症状,但诊断可能会延迟。因此,虽然它们通常在婴儿中发现,但在成人中极为罕见。我们在此报告一例成人罕见的无闭锁支气管食管瘘病例。

病例

一名69岁男性因进食后尤其是液体食物后立即出现长达数十年的咳嗽伴咳痰症状就诊于门诊。计算机断层扫描、食管镜检查和食管造影显示食管中段与右下叶支气管之间存在瘘道相通,右下叶有实变。我们进行了右下叶切除术并闭合和切除了瘘管。瘘管的组织病理学显示黏膜内衬复层鳞状上皮。没有炎症、肉芽肿或癌的证据。

结论

总之,尽管这种畸形本质上是良性的,但如果不治疗,可能会导致与瘘管相关的长期使人衰弱的呼吸道症状。因此,在评估复发性肺部感染时应考虑进行诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df4b/5985245/3944487e98ec/gr1.jpg

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