Oesophageal-pleural fistula

An oesophageal-pleural fistula refers to an abnormal connection between the oesophagus and pleura. 

Pathology

They can arise from a number of underlying pathologies which can result in an oesophageal rupture ³:

• post surgical
• endoscopic procedures
  • post oesophageal dilatation
• secondary to a tumour, e.g. oesophageal carcinoma
• oesophageal tuberculosis ⁶ 
• from chemical injury following ingestion of corrosive substances
• from irradiation

Radiographic features

CT

Thoracic CT with oesophageal (oral) contrast may show a direct communication with the pleural space. Air in the pleural space +/- hydropneumothorax in correct clinical setting may also be useful in the diagnosis.