Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

Abstract

Esophageal diverticulum with secondary bronchoesophageal fistula is a rare clinical entity that manifests as respiratory infections, coughing during eating or drinking, hemoptysis, and sometimes fatal complications. In the present study, we describe a case of bronchoesophageal fistula emanating from esophageal diverticulum in a 45-year-old man who presented with bronchiectasis. We summarize the characteristics of this rare condition based on a review of the relevant literature.

Keywords: Esophageal diverticulum; bronchiectasis; bronchoesophageal fistula; congenital BEF; literature review; postprandial cough.

Figure 1.

Computed tomography scan revealed bronchial dilatation in the dorsal segment of the left lower lobe with chronic pulmonary abscess surrounding it. A suspected fistulous communication between the middle esophagus and the left intermediate bronchus was indicated. There was no mediastinitis or lymphadenopathy.

Figure 2.

A Lipiodol (iodine) swallow revealed a medium-sized diverticulum at the left lateral aspect of the esophagus, which had developed a fistulous connection with the left lower lobe bronchus.

Figure 3.

Esophagoscopy showed the diverticulum 33 cm from the upper incisors, with a 3-mm fistulous orifice arising from its apex.