A Successful Treatment of Broncho-Esophageal Fistula with Esophageal Stenting Using Direct Endoscopic Visualization

Medicina (Kaunas). 2024 Mar 22;60(4):524. doi: 10.3390/medicina60040524.

Abstract

Broncho-esophageal fistula (BEF) is a severe yet relatively rare connection between the bronchus and esophagus usually caused by esophageal and pulmonary malignancies. We present a case report of a 49-year-old man diagnosed with terminal lung carcinoma who developed a BEF. The thoracic computed tomography scan detected a mass in the left bronchi that partially covers and disrupts the bronchial contour in certain regions and extends to the esophageal wall. After thoroughly evaluating alternative treatment approaches, we opt for the stenting procedure due to the advanced stage of the tumor and the significantly diminished quality of life. The treatment involves the use of a partially covered metal stent that is known to exhibit lower potential to migrate. The treatment is highly successful, resulting in a significant enhancement of the patient's quality of life, a lengthening in his survival, and the ability to pursue additional palliative treatment options. In contrast to the typical prosthesis implantation, our procedure uses a direct endoscopic visualization for the proximal deployment of a partially covered stent, offering a cost-effective and radiation-free alternative that can be particularly beneficial for BEF patients in facilities without radiology services.

Keywords: broncho-esophageal fistula; bronchopulmonary adenocarcinoma; lung carcinoma; self-expanding metal stent (SEMS); stenting.

Publication types

  • Case Reports

MeSH terms

  • Bronchial Fistula* / surgery
  • Esophageal Fistula* / etiology
  • Esophageal Fistula* / surgery
  • Humans
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Stents*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Grants and funding

We would like to acknowledge VICTOR BABES UNIVERSITY OF MEDICINE AND PHARMACY TIMISOARA for their support in covering the costs of publication for this research paper.