Fístula broncoesofágica y broncolitiasis

Carvajal Balaguera, J.; Mallagray Casas, S.; Martínez Cruz, R.; Dancausa Monge, A.

doi:10.1016/S0300-2896(15)30947-9

Archivos de Bronconeumología

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Vol. 31. Issue 4.

Pages 184-187 (April 1995)

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Pages 184-187 (April 1995)

DOI: 10.1016/S0300-2896(15)30947-9

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Fístula broncoesofágica y broncolitiasis

Bronchoesophageal fístula and broncholithiasis

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J. Carvajal Balaguera*,1, S. Mallagray Casas*, R. Martínez Cruz**, A. Dancausa Monge**

* Servicio de Cirugía General y Torácica. Hospital Central Cruz Roja

** Servicio de Neumología. Hospital Universitario de Getafe. Madrid

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Las fístulas broncoesofágicas (FBE) benignas en el adulto, tanto de origen congénito como adquirido, son entidades poco frecuentes, pero la perforación broncoesofágica secundaria a broncolitiasis, debida a adenopatías mediastínicas calcificadas dejando un trayecto fistuloso, es un proceso excepcional.

Nosotros presentamos un caso de una FBE en una paciente de 57 años de edad, que se inició con tos, expectoración de broncolitos, hemoptisis y tos tras la ingesta de alimentos líquidos y sólidos. La radiografía y la TAC del tórax mostraron adenopatías mediastínicas calcificadas. La endoscopia esofágica fue normal. El esofagograma mostró un trayecto fistuloso a nivel de 1/3 medio del esófago justo debajo de la carina. La broncoscopia señaló una área polipoide localizada en la cara medial del bronquio principal derecho. No hubo signos histológicos de malignidad.

La paciente se intervino quirúrgicamente. Se extirpó el trayecto fistuloso interponiendo una banda de pleura tras realizar una toracotomía posterolateral derecha. El postoperatorio cursó sin incidencia y se encuentra en la actualidad libre de síntomas.

Palabras clave:

Fístula broncoesofágica adquirida

Broncolitiasis

Tuberculosis ganglios linfáticos mediastínicos

Bronchoesophagel fístulas (BEF) in an adult, wether acquired or congenital, are uncommon but bronchoesophageal perforation secondary to broncholithiasis caused by calcified mediastinal adenopaty and leading to the formation of a fistulous tract is extremely rare.

We present a case of acquired BEF in a 57-years-old women who presented cough with expectoration of broncholithos, hemoptysis and cough after swalloing liquid or solid foods. The chest film and computed tomographic sean showed calcified mediastinal adenopathy. Endoscopic examination of the esophagus revealed no mucosal abnormality. A bronchial esophageal fístula was identified at the level of the 1/3 midesophagus just helo» the carina in the esophagogram. The bronchoscopy showed a polypoid area located in the medial side of the right main bronchus. There was no evidence of neoplasm.

The patient underwent excision of fístula and interposition of pleural bundle after completing a right posterolateral thoracotomy. The postoperative course was uneventful and the patient has been doing well on follow-up.

Key words:

Acquired bronchoesophageal fístula

Broncholitiasis

Tuberculous mediastinal lymph nodes

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