Deb S, Ali M B, Fonseca P
Department of Surgery, National Naval Medical Center, Bethesda, MD 20889, USA.
Chest. 1998 Dec;114(6):1784-6. doi: 10.1378/chest.114.6.1784.
We present a rare case of a congenital bronchoesophageal fistula in a 54-year-old woman with a history of poor feeding tolerance since infancy and repeated pulmonary infections. She initially presented with epigastric and right upper quadrant abdominal pain. Her workup included a barium esophagogram that revealed a fistula between her midesophagus and a left lower lobe segmental bronchus. The fistula was divided, a left lower lobe superior segmentectomy was performed, and an intercostal muscle was placed over the esophageal closure. The patient noted an immediate decrease of postprandial coughing. Congenital respiratory esophageal fistulas that are not associated with esophageal atresia may persist into adulthood before they become clinically apparent. The diagnosis should be considered in certain individuals with suggestive symptomatology and unexplained respiratory pathology.
我们报告一例罕见的先天性支气管食管瘘病例，患者为一名54岁女性，自婴儿期起就有喂养耐受性差和反复肺部感染的病史。她最初表现为上腹部和右上腹疼痛。她的检查包括钡剂食管造影，结果显示她的食管中段与左下叶段支气管之间存在瘘管。瘘管被分离，进行了左下叶上段切除术，并在食管闭合处覆盖了肋间肌。患者术后即刻出现餐后咳嗽减轻。与食管闭锁无关的先天性呼吸性食管瘘可能在临床上出现之前持续到成年期。对于有提示性症状和不明原因呼吸病理的特定个体，应考虑进行诊断。
