Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Dec;4(4):508-13.
doi: 10.5009/gnl.2010.4.4.508. Epub 2010 Dec 17.

Benign bronchoesophageal fistula in adults: endoscopic closure as primary treatment

Ji Yong Ahn  1 , Hwoon-Yong Jung, Ji Young Choi, Mi-Young Kim, Jeong Hoon Lee, Kwi-Sook Choi, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Jin-Ho Kim
Affiliations

Benign bronchoesophageal fistula in adults: endoscopic closure as primary treatment

Ji Yong Ahn et al. Gut Liver. 2010 Dec.

Abstract

Background/aims: Benign bronchoesophageal fistula (BEF) is a rare condition that is usually treated surgically; however, less invasive endoscopy procedures have been attempted to overcome the disadvantages of surgery. The aim of this study was thus to determine the results of endoscopic management as a primary treatment in patients with BEF.

Methods: We retrospectively analyzed data from 368 patients with BEF who were treated at a tertiary care, academic medical center between January 2000 and August 2009.

Results: Benign causes were found for only 18 of the 368 patients. Of these, seven were treated endoscopically and the others by surgery or other methods. The first endoscopy procedures failed in all seven patients, with second trials of endoscopy performed in four patients at a median of 8 days (range, 3 to 11 days) after the first procedure. The second endoscopic procedure was successful in two out of four patients; one patient showed no recurrence of the fistula, whereas the second patient experienced a recurrence after 24 months. All patients underwent successful surgical procedures after the failure of endoscopic treatment, with no further recurrences.

Conclusions: Although we observed a low rate of success for primary endoscopic treatment of benign BEF, the invasive nature of surgery suggests the need for a prospective study with a large number of patients to evaluate the efficacy of less invasive procedures such as endoscopic treatment.

Keywords: Endoscopy; Esophageal fistula; Fibrin glue.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
(A) Fistula opening located 31 cm from the upper incisor. (B) Injection of fibrin glue into the area of the fistula opening. (C) Application of two hemoclips to the site of the fistula opening after the injection of fibrin glue.
Fig. 2
Fig. 2
Esophagography showing the communication between the right lower lobar bronchus with the esophageal cleft in the middle of the esophagus, a finding compatible with a bronchoesophageal fistula.
Fig. 3
Fig. 3
The method of fibrin glue injection. (A) First injection into the opening site, and the second and third injections into the perifistula site. (B) Closing the fistula tract by sealing and compression with fibrin glue.
See this image and copyright information in PMC

References

    1. Woods D, Franic S, Lighter M, Bennett WF. Benign, atraumatic, bronchoesophageal fistulae. Can Assoc Radiol J. 1988;39:68–71. - PubMed
    1. Lado Lado FL, Golpe Gomez A, Cabarcos Ortiz de Barron A, Antunez Lopez JR. Bronchoesophageal fistulae secondary to tuberculosis. Respiration. 2002;69:362–365. - PubMed
    1. Mangi AA, Gaissert HA, Wright CD, et al. Benign broncho-esophageal fistula in the adult. Ann Thorac Surg. 2002;73:911–915. - PubMed
    1. Murdock A, Moorehead RJ, Tham TC. Closure of a benign bronchoesophageal fistula with endoscopic clips. Gastrointest Endosc. 2005;62:635–638. - PubMed
    1. Griffo S, Stassano P, Iannelli G, et al. Benign bronchoesophageal fistula: report of four cases. J Thorac Cardiovasc Surg. 2007;133:1378–1379. - PubMed

LinkOut - more resources