Carvajal Balaguera J, Mallagray Casas S, Martínez Cruz R, Dancausa Monge A
Servicio de Cirugía General y Torácica, Hospital Central Cruz Roja, Madrid.
Arch Bronconeumol. 1995 Apr;31(4):184-7.
Bronchoesophageal fistulas (BEF) in an adult, whether acquired or congenital, are uncommon but bronchoesophageal perforation secondary to broncholithiasis caused by calcified mediastinal adenopathy and leading to the formation of a fistulous tract is extremely rare. We present a case of acquired BEF in a 57-years-old women who presented cough with expectoration of broncholiths, hemoptysis and cough after swallowing liquid or solid hemoptysis and cough after swallowing liquid or solid foods. The chest film and computed tomographic scan showed calcified mediastinal adenopathy. Endoscopic examination of the esophagus revealed no mucosal abnormality. A bronchial esophageal fistula was identified at the level of the 1/3 midesophagus just below the carina in the esophagogram. The bronchoscopy showed a polypoid area located in the medial side of the right main bronchus. There was no evidence of neoplasm. The patient underwent excision of fistula and interposition of pleural bundle after completing a right posterolateral thoracotomy. The postoperative course was uneventful and the patient has been doing well on follow-up.
成人支气管食管瘘（BEF），无论是后天性还是先天性，都不常见，但由钙化纵隔淋巴结病引起支气管结石继发支气管食管穿孔并导致瘘道形成极为罕见。我们报告一例57岁女性后天性BEF病例，该患者表现为咳嗽伴咳出支气管结石、咯血以及吞咽液体或固体食物后咳嗽。胸部X线片和计算机断层扫描显示钙化纵隔淋巴结病。食管内镜检查未发现黏膜异常。食管造影显示在隆突下方食管中1/3处有支气管食管瘘。支气管镜检查显示右主支气管内侧有一息肉样区域。没有肿瘤证据。患者在完成右后外侧开胸术后接受了瘘管切除和胸膜束置入术。术后过程顺利，患者随访情况良好。
