Emergency computerized tomography of tracheoesophageal fistula in lung adenocarcinoma.

Malignant tracheoesophageal fistula occurs infrequently in patients with irradiated esophageal and lung cancer, uncommonly in patients with untreated mediastinal malignancies, infection, or trauma, and rarely in primary adenocarcinoma of the lung. The natural progression of this entity leads to rapid deterioration and death from overwhelming pulmonary infection.Definitive treatment depends on the demonstration and localization of the fistula. Computerized tomography (CT) chest scanning with dilute oral contrast is the ideal means of identification of the fistula. CT scanning without contrast may outline sufficiently the pathology to avoid the usage and side effects of contrast media in the lungs.A review of one case of tracheoesophageal fistula due to pulmonary adenocarcinoma is presented where emergency CT scanning without contrast resulted in rapid and accurate diagnosis, leading to prompt and appropriate management.