Congenital bronchoesophageal fistulas in adult patients

Background. Congenital bronchoesophageal fistulas have rarely been reported. Presented here is the 14-year experience of our hospital with this lesion. Methods. The study comprises 13 patients; 9 had a Braimbridge type II fistula; 2, a type I fistula; and 2, a type IV fistula. The most frequent site of communication was between the middle esophagus and the right lower lobe of the lung, especially the superior segment. A fistulectomy, with or without pulmonary resection, was performed on each patient. Results. All patients had complete relief of symptoms. No operative complications were observed. Conclusions. Congenital bronchoesophageal fistulas in adults are usually diagnosed by an esophagography. Symptoms are often nonspecific, and the possibility of a congenital bronchoesophageal fistula should be considered in patients who complain of long-standing unexplainable respiratory symptoms such as coughing and frequent pulmonary infections. The surgical intervention is relatively simple. In many cases, a fistulectomy with simple closure of the openings in both the esophagus and the bronchus is all that is required. Pulmonary resection is needed in some patients with severe bronchiectasis and recurrent pneumonitis.