array:24 [
  "pii" => "S0300289617302636"
  "issn" => "03002896"
  "doi" => "10.1016/j.arbres.2017.07.010"
  "estado" => "S300"
  "fechaPublicacion" => "2018-03-01"
  "aid" => "1691"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2017"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Arch Bronconeumol. 2018;54:157"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1224
    "formatos" => array:3 [
      "EPUB" => 146
      "HTML" => 722
      "PDF" => 356
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S1579212918300284"
      "issn" => "15792129"
      "doi" => "10.1016/j.arbr.2017.07.019"
      "estado" => "S300"
      "fechaPublicacion" => "2018-03-01"
      "aid" => "1691"
      "copyright" => "SEPAR"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "Arch Bronconeumol. 2018;54:157"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 989
        "formatos" => array:3 [
          "EPUB" => 156
          "HTML" => 546
          "PDF" => 287
        ]
      ]
      "en" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>"
        "titulo" => "Tuberculous Tracheoesophageal Fistula&#58; A Rare Entity"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "157"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "F&#237;stula traqueoesof&#225;gica tuberculosa&#58; una entidad poco com&#250;n"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Fig&#46; 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1798
                "Ancho" => 1708
                "Tamanyo" => 259312
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A fistulous tract between the trache and esophagus seen on both CT scan of the chest &#40;A&#41; and barium esophagogram &#40;B&#41;&#46; The bronchoscopy images showing the fistulous tract in the distal right posterior trachea &#40;C&#41; which was healed following antituberculous treatment &#40;D&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Ala-Eddin S&#46; Sagar, Sujith V&#46; Cherian, Rosa M&#46; Estrada-Y-Martin"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Ala-Eddin S&#46;"
                "apellidos" => "Sagar"
              ]
              1 => array:2 [
                "nombre" => "Sujith V&#46;"
                "apellidos" => "Cherian"
              ]
              2 => array:2 [
                "nombre" => "Rosa M&#46;"
                "apellidos" => "Estrada-Y-Martin"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0300289617302636"
          "doi" => "10.1016/j.arbres.2017.07.010"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617302636?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212918300284?idApp=UINPBA00003Z"
      "url" => "/15792129/0000005400000003/v3_201803080856/S1579212918300284/v3_201803080856/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S030028961730279X"
    "issn" => "03002896"
    "doi" => "10.1016/j.arbres.2017.07.022"
    "estado" => "S300"
    "fechaPublicacion" => "2018-03-01"
    "aid" => "1703"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2018;54:158"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3396
      "formatos" => array:3 [
        "EPUB" => 142
        "HTML" => 2651
        "PDF" => 603
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Imagen cl&#237;nica</span>"
      "titulo" => "Diagn&#243;stico de infarto pulmonar mediante ecograf&#237;a tor&#225;cica"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "158"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Diagnosis of Pulmonary Infarction by Thoracic Ultrasonography"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1834
              "Ancho" => 1613
              "Tamanyo" => 255487
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ecograf&#237;a y TAC tor&#225;cico con defecto de repleci&#243;n en arterias segmentarias del LID y consolidaci&#243;n subpleural de morfolog&#237;a triangular con base pleural&#44; diagn&#243;stico de TEP con infarto pulmonar&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Sergi Pascual-Guardia, Mar&#237;a Pilar Ausin-Herrero, Enric Ripoll-Fuster"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Sergi"
              "apellidos" => "Pascual-Guardia"
            ]
            1 => array:2 [
              "nombre" => "Mar&#237;a Pilar"
              "apellidos" => "Ausin-Herrero"
            ]
            2 => array:2 [
              "nombre" => "Enric"
              "apellidos" => "Ripoll-Fuster"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S1579212918300065"
        "doi" => "10.1016/j.arbr.2018.01.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212918300065?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961730279X?idApp=UINPBA00003Z"
    "url" => "/03002896/0000005400000003/v2_202107140901/S030028961730279X/v2_202107140901/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0300289617302132"
    "issn" => "03002896"
    "doi" => "10.1016/j.arbres.2017.06.007"
    "estado" => "S300"
    "fechaPublicacion" => "2018-03-01"
    "aid" => "1661"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2018;54:156"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1226
      "formatos" => array:3 [
        "EPUB" => 144
        "HTML" => 704
        "PDF" => 378
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Clinical image</span>"
      "titulo" => "A Case of a Carcinoid Tumour With Diffuse Tracheal Invasion"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "156"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Caso de tumor carcinoide con invasi&#243;n difusa de la tr&#225;quea"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 904
              "Ancho" => 990
              "Tamanyo" => 82736
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tracheal lesions on the thorax computered tomography of the patient &#40;a&#41; Endobronchial view before &#40;b&#41; and after treatment &#40;c&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Cengiz &#214;zdemir, Sinem Nedime S&#246;k&#252;c&#252;"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Cengiz"
              "apellidos" => "&#214;zdemir"
            ]
            1 => array:2 [
              "nombre" => "Sinem Nedime"
              "apellidos" => "S&#246;k&#252;c&#252;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S1579212918300272"
        "doi" => "10.1016/j.arbr.2017.06.011"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212918300272?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617302132?idApp=UINPBA00003Z"
    "url" => "/03002896/0000005400000003/v2_202107140901/S0300289617302132/v2_202107140901/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>"
    "titulo" => "Tuberculous Tracheoesophageal Fistula&#58; A Rare Entity"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "157"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Ala-Eddin S&#46; Sagar, Sujith V&#46; Cherian, Rosa M&#46; Estrada-Y-Martin"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "Ala-Eddin S&#46;"
            "apellidos" => "Sagar"
            "email" => array:1 [
              0 => "alaeddin.sagar@gmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Sujith V&#46;"
            "apellidos" => "Cherian"
          ]
          2 => array:2 [
            "nombre" => "Rosa M&#46;"
            "apellidos" => "Estrada-Y-Martin"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Divisions of Critical Care&#44; Pulmonary and Sleep Medicine&#44; University of Texas Health-McGovern Medical School&#44; TX&#44; USA"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "F&#237;stula traqueoesof&#225;gica tuberculosa&#58; una entidad poco com&#250;n"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1798
            "Ancho" => 1708
            "Tamanyo" => 233050
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A fistulous tract between the trache and esophagus seen on both CT scan of the chest &#40;A&#41; and barium esophagogram &#40;B&#41;&#46; The bronchoscopy images showing the fistulous tract in the distal right posterior trachea &#40;C&#41; which was healed following antituberculous treatment &#40;D&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 46-year-old male&#44; HIV seronegative&#44; smoker&#44; with non-insulin dependent diabetes mellitus presented with complaints of cough&#44; weight loss and dysphagia of six months&#8217; duration&#46; Chest X-ray&#44; followed by CT scans &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41; revealed a right upper lobe cavity with a fistulous communication between the trachea and esophagus&#46; Sputum stains were positive for acid fast bacilli consistent with <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> and the patient was started on antituberculous treatment&#46; A barium esophagogram revealed the presence of a fistulous tract from the esophagus &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#44; following which an endoscopic gastroduodenoscopy showed a 2&#46;5<span class="elsevierStyleHsp" style=""></span>cm defect in the upper esophagus with a visible fistulous track&#46; Bronchoscopy demonstrated the fistulous tract at the distal right posterior trachea &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41;&#46; He was managed conservatively with percutaneous gastrostomy feeding and discharged on direct observed therapy for tuberculosis with <span class="elsevierStyleItalic">Rifampicin</span>&#44; isoniazid&#44; pyrazinamide&#44; ethambutol and vitamin B6&#46; After 6 months of treatment&#44; his dysphagia resolved&#46; A repeat barium esophagogram and bronchoscopy &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>D&#41; showed interval healing of the tracheoesophageal fistula&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Tracheoesophageal fistulas mostly occur as an acquired complication due to malignancy&#44; granulomatous infections&#44; trauma and post endotracheal intubation&#46; Tracheoesophageal fistulas caused by tuberculosis are an exceedingly rare complication&#44; and have been postulated to occur secondary to rupture of caseous peribronchial lymph nodes into adjacent mediastinal structures with subsequent fistula formation&#46; The best course of management is unclear&#46; While certain cases have been managed surgically&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> others reported successful resolution of the fistula with medical management alone<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> as seen in our case&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1798
            "Ancho" => 1708
            "Tamanyo" => 233050
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A fistulous tract between the trache and esophagus seen on both CT scan of the chest &#40;A&#41; and barium esophagogram &#40;B&#41;&#46; The bronchoscopy images showing the fistulous tract in the distal right posterior trachea &#40;C&#41; which was healed following antituberculous treatment &#40;D&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:2 [
            0 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tracheoesophageal fistula in AIDS&#58; stent versus primary repair"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Rosario"
                            1 => "J&#46; Song"
                            2 => "W&#46; Wittenborn"
                            3 => "F&#46; Christian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/apc.1996.10.334"
                      "Revista" => array:6 [
                        "tituloSerie" => "AIDS Patient Care STDs"
                        "fecha" => "1996"
                        "volumen" => "10"
                        "paginaInicial" => "334"
                        "paginaFinal" => "335"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11361547"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculous bronchoesophageal fistulae in patients infected with the human immunodeficiency virus&#58; three case reports and review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;C&#46; Porter"
                            1 => "J&#46;S&#46; Friedland"
                            2 => "A&#46;R&#46; Freedman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/clinids/19.5.954"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "1994"
                        "volumen" => "19"
                        "paginaInicial" => "954"
                        "paginaFinal" => "957"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7893888"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/03002896/0000005400000003/v2_202107140901/S0300289617302636/v2_202107140901/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "45361"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Imagen cl&#237;nica"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005400000003/v2_202107140901/S0300289617302636/v2_202107140901/en/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617302636?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 54. Issue 3.
Pages 157 (March 2018)
Share
Share
Download PDF
More article options
Vol. 54. Issue 3.
Pages 157 (March 2018)
Clinical Image
Full text access
Tuberculous Tracheoesophageal Fistula: A Rare Entity
Fístula traqueoesofágica tuberculosa: una entidad poco común
Visits
5034
Ala-Eddin S. Sagar
Corresponding author
alaeddin.sagar@gmail.com

Corresponding author.
, Sujith V. Cherian, Rosa M. Estrada-Y-Martin
Divisions of Critical Care, Pulmonary and Sleep Medicine, University of Texas Health-McGovern Medical School, TX, USA
This item has received
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Full Text

A 46-year-old male, HIV seronegative, smoker, with non-insulin dependent diabetes mellitus presented with complaints of cough, weight loss and dysphagia of six months’ duration. Chest X-ray, followed by CT scans (Fig. 1A) revealed a right upper lobe cavity with a fistulous communication between the trachea and esophagus. Sputum stains were positive for acid fast bacilli consistent with Mycobacterium tuberculosis and the patient was started on antituberculous treatment. A barium esophagogram revealed the presence of a fistulous tract from the esophagus (Fig. 1B), following which an endoscopic gastroduodenoscopy showed a 2.5cm defect in the upper esophagus with a visible fistulous track. Bronchoscopy demonstrated the fistulous tract at the distal right posterior trachea (Fig. 1C). He was managed conservatively with percutaneous gastrostomy feeding and discharged on direct observed therapy for tuberculosis with Rifampicin, isoniazid, pyrazinamide, ethambutol and vitamin B6. After 6 months of treatment, his dysphagia resolved. A repeat barium esophagogram and bronchoscopy (Fig. 1D) showed interval healing of the tracheoesophageal fistula.

Fig. 1.

A fistulous tract between the trache and esophagus seen on both CT scan of the chest (A) and barium esophagogram (B). The bronchoscopy images showing the fistulous tract in the distal right posterior trachea (C) which was healed following antituberculous treatment (D).

(0.22MB).

Tracheoesophageal fistulas mostly occur as an acquired complication due to malignancy, granulomatous infections, trauma and post endotracheal intubation. Tracheoesophageal fistulas caused by tuberculosis are an exceedingly rare complication, and have been postulated to occur secondary to rupture of caseous peribronchial lymph nodes into adjacent mediastinal structures with subsequent fistula formation. The best course of management is unclear. While certain cases have been managed surgically,1 others reported successful resolution of the fistula with medical management alone2 as seen in our case.

References
[1]
P. Rosario, J. Song, W. Wittenborn, F. Christian.
Tracheoesophageal fistula in AIDS: stent versus primary repair.
AIDS Patient Care STDs, 10 (1996), pp. 334-335
[2]
J.C. Porter, J.S. Friedland, A.R. Freedman.
Tuberculous bronchoesophageal fistulae in patients infected with the human immunodeficiency virus: three case reports and review.
Clin Infect Dis, 19 (1994), pp. 954-957
Copyright © 2017. SEPAR
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?