Sayeed Ahmed, Alqurashi Eid Humaid, Alzanbagi Adnan B, Ghaleb Nabil Abdulwadod Badr
Department of Pulmonology, King Abdullah Medical City, Mecca, Saudi Arabia.
Department of Gastroenterology, King Abdullah Medical City, Mecca, Saudi Arabia.
BMJ Case Rep. 2017 Jul 31;2017:bcr-2017-220821. doi: 10.1136/bcr-2017-220821.
A 21-year-old Saudi man presented with a history of dysphagia and choking. CT scan of the chest showed clear evidence of chronic recurrent aspiration pneumonia in the left lung. It also showed a fistula connecting the left main bronchus to the oesophagus. Endoscopy showed clear opening on the oesophageal side. Bronchoscopy also confirmed the presence of a broncho-oesophageal fistula on the left bronchial side with the presence of secretions on swallowing. Bronchoalveolar lavage (BAL) was done and sent for mycobacterial tuberculosis culture. The fistula was closed with clips under endoscopic guidance, which alleviated his symptoms of dysphagia and choking. The BAL culture grew mycobacterial tubercle bacilli. The patient showed marked improvement after starting antitubercular therapy and was discharged to be followed up in the clinic.
一名21岁的沙特男子出现吞咽困难和呛咳病史。胸部CT扫描显示左肺有慢性复发性吸入性肺炎的确切证据。还显示有一个瘘管连接左主支气管和食管。内镜检查显示食管侧有明显开口。支气管镜检查也证实左支气管侧存在支气管食管瘘，吞咽时有分泌物。进行了支气管肺泡灌洗（BAL）并送去进行结核分枝杆菌培养。在内镜引导下用夹子封闭了瘘管，这缓解了他的吞咽困难和呛咳症状。BAL培养长出了结核分枝杆菌。患者开始抗结核治疗后症状明显改善，随后出院并在门诊随访。
