Spontaneous esophagotracheal fistula resulting from ulcer in heterotopic gastric mucosa

Abstract

In a 50-yr-old male patient, a spontaneously perforating peptic ulcer located in a patch of heterotopic gastric mucosa in the upper part of the esophagus led to the development of an esophagotracheal fistula. The histologic workup revealed, in addition to ulcer necroses and granulation tissue, glands of the fundic type, with chief and parietal cells. On the basis of histologic results, the fistula was successfully occluded with the aid of a fibrin adhesive applied endoscopically. After the second session, the patient immediately became free of symptoms. Under medical treatment with an H2-receptor blocker, the patient has been completely symptom-free for 1 yr.