Broncho-esophageal fistula

Broncho-esophageal fistula (BOF) refers to abnormal communication between a bronchus and the esophagus.

For congenital fistulas, please refer to the article on congenital tracheo-esophageal fistula.

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 hemoptysis.

Pathology

Etiology

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

• esophageal cancer: can complicate 5-15% of cases ²
• percutaneous endoscopic gastronomy (rare) ¹
• complication of acute radiation-induced esophagitis
• infective etiology affecting the esophagus ^3,4
  • esophageal tuberculosis
  • esophageal syphilis
  • esophageal histoplasmosis
  • esophageal actinomycosis
  • esophageal candidiasis

Treatment and prognosis

Complications

• recurrent pulmonary infection and sepsis

See also

• tracheo-esophageal fistula
• bronchopleural fistula