Presentation
Patient with a history of squamous esophageal cancer. She underwent chemotherapy and radiotherapy with subsequent placement of a metal stent for impassable stenosis in the upper third, which was removed due to pain.
Patient Data
Surgical staples in the left lower lobe.
Extraluminal gas anterior to the proximal-to-middle third of the esophagus follows a lateral and anterior trajectory to the trachea observing a small defect in the anterior wall of the trachea compatible with tracheoesophageal fistula.
Alteration of the periesophageal fatty planes is observed.
No adenomegaly in axillae, hilar or mediastinum.
No pericardial or pleural effusion is identified.
Concentric thickening of bronchial walls of inflammatory origin.
Nodular and ground-glass opacities of peribronchial and centrolobular distribution persist in both lungs, predominantly in the lower lobes. Suggestive of inflammatory / infectious process with small airway involvement.
Case Discussion
This case demonstrates a tracheoesophageal fistula as a complication of a metallic stent placed due to esophageal stenosis resulting from squamous esophageal cancer.
This patient presented persistent cough and due to his previous history a fistula was suspected.
It is important in these cases to always think of aspiration pneumonia as a possible complication.
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