Anzeige
Erschienen in:
23.01.2018 | GI Image
Esophagobronchial Fistula as the Initial Manifestation of an Esophageal Cancer: Radiological Demonstration
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 9/2018
Einloggen, um Zugang zu erhaltenExcerpt
A chest radiograph in a 69-year-old patient complaining of cough and shortness of breath (without dysphagia) showed an ill-defined azygoesophageal recess and scattered peribronchial opacities in the right lung base. A thoracic computed tomography (CT) showed a mass in the lower third of the esophagus (Fig. 1) infiltrating the mediastinal pleura and the medial basal segment of the right lower lobe (RLL). The CT images demonstrated the presence of multiple aligned gas bubbles within the mass interposed between the esophageal lumen and a subsegmental bronchus of the medial basal segment of the RLL (Fig. 2), consistent with an esophagobronchial fistula (EBF). A barium swallow study confirmed the EBF (Fig. 3) and an upper endoscopy confirmed an esophageal adenocarcinoma (not shown).
Fig. 1
Axial thoracic CT image (mediastinal window) shows an esophageal mass (asterisk) infiltrating the pleural surface and the RLL (arrows)
Fig. 2
Axial thoracic CT image (lung window, minimum intensity projection –minIP) demonstrates multiple small gas bubbles (black arrows) interposed between the esophageal lumen (asterisk) and a subsegmental bronchus of the medial basal segment of the RLL (white arrow)
Fig. 3
Barium swallow study image shows an ulcerated esophageal mass (M) and demonstrates extravasation of oral contrast through a fistulous tract (black arrows) that communicates the esophageal lumen with a subsegmental bronchus (white arrow)
× ![]()
× ![]()
× ![]()
…