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Broncho-esophageal fistula

Case contributed by Vincent Tatco
Diagnosis probable

Presentation

Known case of bronchiectasis of the left lung. Patient presented with cough after the ingestion of food.

Patient Data

Age: 35 years
Gender: Male

Chest

ct

Cystic bronchiectasis, some with mucous plugging, fibrosis, cicatricial atelectasis and minimal calcifications are demonstrated in the lingula of the left upper lobe and basal segments of the left lower lobe.

There are reticulonodular and patchy ground glass opacities in the left lower lobe and lingula . In addition, there are minimal patchy ground glass opacities in the posterior segment of the right upper lobe likely due to ongoing infection.  

The entire esophagus is markedly dilated.  There is a 2.0-mm communication between the left mainstem bronchus and dilated esophagus. Findings are consistent with broncho-esophageal fistula.

Barium

On barium swallow, there is demonstration of a small communication between the dilated esophagus and left mainstem bronchus with pooling of contrast in the left lower lobe bronchus.

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