Broncho-oesophageal fistula

Broncho-oesophageal fistula (BOF) refers to an abnormal communication between a bronchus and the oesophagus.

Clinical presentation

A small proportion of patient with congenital forms may present in adulthood. A common presenting feature is with recurrent pulmonary infections with other uncommon presentations being recurrent coughing bouts with meals and rarely haemoptysis.

Pathology

Aetiology

BOF can be either congenital or acquired, with the latter including:

• oesophageal cancer: can complicate 5-15% of cases ²
• percutaneous endoscopic gastronomy (rare) ¹
• infective aetiology affecting the oesophagus ^3,4
  • oesophageal tuberculosis
  • oesophageal syphilis
  • oesophageal histoplasmosis
  • oesophageal actinomycosis
  • oesophageal candidiasis

Complications

• recurrent pulmonary infection and sepsis

Related pathology

• tracheo-oesophageal fistula
• bronchopleural fistula