Double-barrel adult congenital broncho-esophageal fistulae-images

Abstract

Congenital broncho-oesophageal fistulae (CBEF) are foregut developmental anomalies. They are formed due to the persistent attachment between the developing tracheal bud and the foregut in the embryo. They commonly present in young age and patients present with symptoms of recurrent respiratory tract infections and low body weight. Only one case of a double CBEF has been reported in literature so far. Here we present a congenital double barrel broncho-oesophageal fistula in a middle aged lady, which is a rare presentation. Definitive treatment involves division and repair of the fistula along with resection of the damaged portion of lung in select cases. We publish these images due to the rarity of a double fistula.

Keywords: Broncho-esophageal fistula; Esophagus congenital anomalies; Surgery.

Fig. 1

Contrast-enhanced computed tomography images (axial and coronal) showing a contrast-filled tract leading into the right lower lobe bronchus

Fig. 2

Barium swallow with arrows showing a proximal and distal contrast-filled linear tracts leading to the right lower lobe bronchus

Fig. 3

Gastroscopy images showing the two congenital broncho-esophageal fistulae

Fig. 4

Intraoperative pictures showing double-barrel congenital broncho-esophageal fistulae and fistulae closure with a pedicled intercostal muscle flap buttress