Esophagopleural fistula

Last revised by Dr Daniel J Bell on 26 Jun 2021

An esophagopleural fistula refers to an abnormal connection between the esophagus and pleura


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

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

Radiographic features


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

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Cases and figures

  • Case 1: spontaneous
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  • Case 2: iatrogenic
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