RESUMO
Endovascular approaches to treating a diseased ascending aorta are challenging. We report the use of an endovascular occlusion device for successful closure of a ruptured penetrating atherosclerotic ulcer of an ascending aorta. A 47-year-old female patient with Takayasu arteritis complained of a worsening hemoptysis. She had a history of Bentall procedure for a sinus of Valsalva aneurysm and redo surgery for a ruptured penetrating atherosclerotic ulcer close to the distal anastomosis. She developed methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis after the second procedure and required negative pressure wound therapy. Computed tomographic angiography revealed recurrence of a ruptured penetrating aortic ulcer and an aortobronchial fistula. Because of the high risk of redo sternotomy after MRSA mediastinitis, we used an endovascular occlusion device to achieve successful percutaneous closure. The patient was discharged without any complications. Postoperative computed tomography scans showed that the endovascular device was positioned without migration and that complete thrombosis of the penetrating atherosclerotic ulcer was achieved. This is the first report on endovascular repair of a ruptured penetrating atherosclerotic ulcer of the ascending aorta in Takayasu arteritis.
Assuntos
Doenças da Aorta/terapia , Fístula Brônquica/terapia , Procedimentos Endovasculares , Arterite de Takayasu/complicações , Úlcera/terapia , Fístula Vascular/terapia , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/etiologia , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/etiologia , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Pessoa de Meia-Idade , Arterite de Takayasu/diagnóstico por imagem , Resultado do Tratamento , Úlcera/diagnóstico por imagem , Úlcera/etiologia , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/etiologiaRESUMO
OBJECTIVE: To investigate the management of early bronchopleural fistula(BPF) within one month after pneumonectomy. METHODS: A total of 30 cases developed BPF within one month after pneumonectomy in recent 30 years were reviewed from First Hospital of Jilin University. All patients were treated by reoperation, closed drainage with or without open thoracic window, or endobronchial glue. RESULTS: Seventeen patients were returned to the operating room for reclosure of BPF, one patients died of BPF and 16 reoperations were successful.Twelve cases were treated by closed drainage with or without followed open thoracic window. In 6 patients who were managed by closed drainage alone, 2 cases died of BPF and 4 bronchopleural fistulas closed spontaneously. In 6 patients treated with closed drainage and later with open thoracic window, one case died of BPF. One patient successfully underwent endoscopic glue to close BPF with injection three times. CONCLUSION: Within one month postoperatively, BPF without established empyema with pus should be reoperated if the patient had enough cardiopulmonary reserve and could there fore tolerate reoperation. Contamination of pleural space is not the contraindication to reoperation. Reclosure via original thoracotomy and repair the fistula with pedicled intercostal muscle flap are convenient and efficient. Drainage with or without followed open thoracic window is appropriate for the patients with limited cardiopulmonary reserve, impaired general condition, secondary to empyema with pus, early recurred cancer, or some small fistulas.
Assuntos
Fístula Brônquica/terapia , Doenças Pleurais/cirurgia , Pneumonectomia/efeitos adversos , Complicações Pós-Operatórias/terapia , Fístula Brônquica/etiologia , Fístula Brônquica/patologia , Drenagem , Humanos , Doenças Pleurais/etiologia , Doenças Pleurais/patologia , Reoperação , Retalhos Cirúrgicos , Toracotomia , Resultado do TratamentoAssuntos
Fístula Brônquica/terapia , Fístula Cutânea/terapia , Fístula Esofágica/terapia , Esofagoscopia/instrumentação , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/etiologia , Pré-Escolar , Fístula Cutânea/diagnóstico por imagem , Fístula Cutânea/etiologia , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/etiologia , Feminino , Humanos , Radiografia Intervencionista , Recidiva , Resultado do TratamentoAssuntos
Técnicas de Ablação/efeitos adversos , Adenocarcinoma de Pulmão/secundário , Adenocarcinoma de Pulmão/cirurgia , Fístula Brônquica/terapia , Embolização Terapêutica/métodos , Embucrilato/administração & dosagem , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Micro-Ondas/efeitos adversos , Doenças Pleurais/terapia , Neoplasias Retais/patologia , Fístula do Sistema Respiratório/terapia , Idoso de 80 Anos ou mais , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/etiologia , Feminino , Humanos , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/etiologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Fístula do Sistema Respiratório/diagnóstico por imagem , Fístula do Sistema Respiratório/etiologia , Resultado do TratamentoAssuntos
Fístula Biliar/terapia , Fístula Brônquica/terapia , Embolização Terapêutica/métodos , Embucrilato/administração & dosagem , Adesivos Teciduais/administração & dosagem , Adulto , Fístula Biliar/diagnóstico por imagem , Fístula Brônquica/diagnóstico por imagem , Colangiografia/métodos , Óleo Etiodado/administração & dosagem , Humanos , Injeções , Masculino , Radiografia Intervencionista , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We report a case of a 50-year-old man with a 10-year history of pedicle screw internal fixation in the thoracic spine and heroin abuse, who presented with sudden-onset massive hemoptysis with hemorrhagic shock and asphyxia. Urgent contrast-enhanced chest computed tomography (CT) characteristically showed thoracic aortic perforation, a paravertebral pseudoaneurysm, and an intrapulmonary hematoma. Emergency percutaneous thoracic endovascular aortic repair (pTEVAR) with the preclose technique using a vascular closure device under local anesthesia achieved success without any complications. The current case highlights the importance of understanding massive hemoptysis caused by an aortobronchial fistula related to pedicle screw impingement in clinical practice and the value of pTEVAR with the preclose technique under local anesthesia in the emergency setting.
Assuntos
Doenças da Aorta/etiologia , Fístula Brônquica/etiologia , Hemoptise/etiologia , Parafusos Pediculares/efeitos adversos , Fusão Vertebral/efeitos adversos , Fusão Vertebral/instrumentação , Vértebras Torácicas/cirurgia , Fístula Vascular/etiologia , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/terapia , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/terapia , Procedimentos Endovasculares , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/terapiaAssuntos
Aorta Torácica/cirurgia , Doenças da Aorta/cirurgia , Implante de Prótese Vascular/efeitos adversos , Fístula Brônquica/terapia , Embolização Terapêutica/métodos , Embucrilato/administração & dosagem , Procedimentos Endovasculares/efeitos adversos , Úlcera/cirurgia , Lesões do Sistema Vascular/terapia , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/lesões , Aortografia/métodos , Fístula Brônquica/diagnóstico , Fístula Brônquica/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Úlcera/diagnóstico , Lesões do Sistema Vascular/diagnóstico , Lesões do Sistema Vascular/etiologiaRESUMO
OBJECTIVE: To summarize the clinical characteristics and therapeutic experience of A/H5N1 infected patient with intractable bronchopleural fistula. METHOD: The data of a patient with A/H5N1 infection complicated with bronchopleural fistula was collected and analyzed. RESULTS: A 44-year-old woman with pneuminian was diagnosed as A/H5N1 infection by reverse-transcription polymerase chain reaction (RT-PCR) in laboratory from the sample of secretion of respiratory tracts. She had exposed to sick or dead poultry 3 days before development of illness. She developed acute respiratory distress syndrome 7 days after onset of sickness. After comprehensive management with antiviral agents, antibiotics, convalescent serum and invasive ventilation, her clinical condition improved and turned to stable. However, 16 days after onset of illness, her clinical situation deteriorated due to ventilator-associated pneumonia, bilateral pneumothorax and persistent right bronchopleural fistula. After partly failure of beside assist thoracoscopy to fix the pleural fistula, transbronchoscopic bronchial occlusion by autoblood was explored and the air leakage stopped soon after occlusion. Three days after the autoblood clot was expectorated out and air leak recurred. Then, bronchopleural fistula on the surface of visceral pleura was successfully blocked by biogel and OB gel through pleural cavity by fibrobronchoscopy. The patient was discharged from the hospital 99 days after onset of illness (at the 94th hospital day). CONCLUSION: Bronchopleural fistula was an intractable complication for patient with A/H5N1 infection. Occlusion operation by biogel and OB gel through bronchoscopy might be an alternative choice for fixing the bronchopleural fistula.
Assuntos
Fístula Brônquica/terapia , Influenza Humana/terapia , Doenças Pleurais/terapia , Adulto , Fístula Brônquica/complicações , Fístula Brônquica/virologia , China , Feminino , Humanos , Virus da Influenza A Subtipo H5N1 , Influenza Humana/complicações , Influenza Humana/virologia , Doenças Pleurais/complicações , Doenças Pleurais/virologia , Resultado do TratamentoRESUMO
The push and slide method is a method of endoscopic bronchial occlusion using an endobronchial Watanabe spigot that facilitates occlusion of the target bronchus rapidly and accurately using a guidewire. We herein report the case of a man who was diagnosed with empyema forming bronchopulmonary fistulae that was successfully treated by endoscopic bronchial occlusion. Because of the multiple fistulae, balloon occlusion was not a favorable therapeutic approach. Instead, the push and slide method was used in order to detect the fistulae. Endoscopic occlusion, particularly that using the push and slide method, may be a valid treatment option for empyema with multiple bronchopulmonary fistulae.
Assuntos
Fístula Brônquica/terapia , Broncoscopia/instrumentação , Empiema Pleural/terapia , Doenças Pleurais/terapia , Fístula do Sistema Respiratório/terapia , Oclusão Terapêutica/instrumentação , Fístula Brônquica/complicações , Broncoscopia/métodos , Empiema Pleural/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/complicações , Derrame Pleural/etiologia , Derrame Pleural/terapia , Fístula do Sistema Respiratório/complicações , Oclusão Terapêutica/métodos , Resultado do TratamentoRESUMO
Sixty-four-year-old female who underwent hemi-hepatectomy for intrahepatic cholangiocarcinoma a year ago presented with biliary sputum, cough and fever. Cross-sectional imaging showed a recurred tumor involving right diaphragmatic area and an abscess formation in liver dome with adjacent right lower lobe of lung. Percutaneous transhepatic biliary drainage and percutaneous drainage of lung abscess were performed. Tubogram showed connections between the lung abscess cavity and multiple distal bronchi, suggesting bronchobiliary fistulas. Two weeks of drainage treatment did not relieve symptoms. We successfully treated intractable bronchobiliary fistula via image-guided percutaneous access to closest distal bronchi near abscess with subsequent tandem placement of vascular plugs.
Assuntos
Fístula Biliar/terapia , Fístula Brônquica/terapia , Embolização Terapêutica/métodos , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Fístula Biliar/complicações , Fístula Biliar/diagnóstico por imagem , Brônquios/diagnóstico por imagem , Fístula Brônquica/complicações , Fístula Brônquica/diagnóstico por imagem , Drenagem , Feminino , Humanos , Abscesso Pulmonar/complicações , Abscesso Pulmonar/diagnóstico por imagem , Abscesso Pulmonar/terapia , Pessoa de Meia-Idade , Radiografia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Patients with bronchial tree lesions feature, in particular, a high risk for developing bronchial fistulae after surgical repair when the clinical situation is complicated by acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and mechanical ventilation is needed. The current authors hypothesised that extracorporeal carbon dioxide removal would significantly decrease inspiratory airway pressures, thus promoting the protection of surgical bronchial reconstruction. Four patients were studied after surgical reconstruction of bronchial fistulae in whom ALI/ARDS developed and mechanical ventilation with positive end-expiratory pressure was required. Gas exchange, tidal volumes, airway pressures, respiratory frequency, vasopressor and sedation requirements were analysed before and after initiation of a pumpless extracorporeal lung assist device (pECLA; NovaLung, Talheim, Germany). Initiation of pECLA treatment enabled a reduction of inspiratory plateau airway pressures from 32.4 to 28.6 cmH(2)O (3.2 to 2.8 kPa), effectively treated hypercapnia (from 73.6 to 53.4 mmHg (9.8 to 7.1 kPa)) and abolished respiratory acidosis (from pH 7.24 to 7.41). All patients survived and were discharged to rehabilitation clinics. In patients after surgical bronchial reconstruction that was complicated by acute lung injury/acute respiratory distress syndrome, use of pumpless extracorporeal carbon dioxide removal was safe and efficient. Initiation of a pumpless extracorporeal lung assist device enabled a less invasive ventilator management, which may have contributed to healing of surgical bronchial repair.
Assuntos
Fístula Brônquica/terapia , Síndrome do Desconforto Respiratório/terapia , Adulto , Brônquios/cirurgia , Fístula Brônquica/complicações , Dióxido de Carbono/metabolismo , Oxigenação por Membrana Extracorpórea/métodos , Feminino , Humanos , Concentração de Íons de Hidrogênio , Masculino , Pessoa de Meia-Idade , Pressão , Troca Gasosa Pulmonar , Respiração Artificial/métodos , Síndrome do Desconforto Respiratório/complicações , Resultado do TratamentoAssuntos
Fístula Brônquica/etiologia , Fístula Brônquica/terapia , Ablação por Cateter/efeitos adversos , Embucrilato/uso terapêutico , Doenças Pleurais/etiologia , Doenças Pleurais/cirurgia , Radiografia Intervencionista/métodos , Adesivos Teciduais/uso terapêutico , Idoso , Fístula Brônquica/diagnóstico por imagem , Humanos , Cuidados Intraoperatórios/métodos , Masculino , Doenças Pleurais/diagnóstico por imagem , Resultado do TratamentoRESUMO
Development of postpneumonectomy empyema with bronchopleural fistula is a life-threatening condition that requires prompt action. Although measures should be taken to prevent bronchopleural fistula at time of pneumonectomy, many patients experience this complication. Management focuses on drainage of the pleural space, control of the pleural infection including repair of the bronchopleural fistula, and obliteration of the residual pleural cavity. Multiple techniques and procedures have been developed over time to achieve these goals. Knowledge of the diverse therapeutic options is important to select the optimal treatment for these complex patients.
Assuntos
Brônquios/cirurgia , Fístula Brônquica/cirurgia , Empiema Pleural/terapia , Doenças Pleurais/cirurgia , Pneumonectomia/efeitos adversos , Esterno/cirurgia , Toracoplastia , Fístula Brônquica/etiologia , Fístula Brônquica/prevenção & controle , Fístula Brônquica/terapia , Empiema Pleural/etiologia , Empiema Pleural/prevenção & controle , Empiema Pleural/cirurgia , Humanos , Doenças Pleurais/etiologia , Doenças Pleurais/prevenção & controle , Doenças Pleurais/terapia , Procedimentos Cirúrgicos Torácicos/métodos , Toracoplastia/efeitos adversosAssuntos
Fístula Brônquica/terapia , Ablação por Cateter/efeitos adversos , Fístula Cutânea/terapia , Embolização Terapêutica/métodos , Parafina/uso terapêutico , Doenças Pleurais/terapia , Idoso , Bandagens , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/etiologia , Fístula Cutânea/diagnóstico por imagem , Fístula Cutânea/etiologia , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Masculino , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/etiologia , Radiografia , Resultado do TratamentoRESUMO
A strategy providing for solution of a number of tactical and technical problems involved in prognosis, prevention and management of postoperative bronchopleural complication after pneumonectomy for lung cancer was suggested. It was followed by a significant decrease in the frequency of bronchopleural fistula, postoperative empyema and lethality from purulent bronchopleural complications.
Assuntos
Fístula Brônquica/terapia , Empiema Pleural/terapia , Neoplasias Pulmonares/cirurgia , Complicações Pós-Operatórias/terapia , Adulto , Idoso , Algoritmos , Fístula Brônquica/diagnóstico , Fístula Brônquica/prevenção & controle , Terapia Combinada , Empiema Pleural/diagnóstico , Empiema Pleural/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonectomia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , SupuraçãoRESUMO
BACKGROUND: Bronchial occlusion with an Endobronchial Watanabe Spigot (EWS) has been shown to be useful in managing prolonged bronchopleural fistulas and intractable hemoptysis. EWS bronchial occlusion using a curette is less technically demanding. This retrospective study evaluated the clinical utility and simplicity of this method. METHODS: A total of 18 consecutive patients (15 men, 3 women, aged 47-85 years) who underwent bronchial occlusion using an EWS from April 2012 to August 2014 were evaluated. The method involves sticking the tip of a curette into an EWS to the first joint, allowing it to be turned in any direction or at any angle. The time required to occlude the target bronchus was measured on routinely recorded digital videos. Other parameters evaluated included success rates, complications, and clinical outcomes. RESULTS: Of the 18 patients, 11 underwent bronchial occlusion for intractable pneumothorax, 5 for postoperative bronchopleural fistula, two for intractable empyema, and one for hemoptysis. Each patient required 1-7 EWSs (median 4). Target bronchi included the right upper (n = 8), left upper (n = 5), right lower (n = 2), left lower (n = 2), and right middle (n = 1) bronchi. The success rate of EWS insertion into the target bronchus was 100%. Time per EWS occlusion ranged from 65-528 sec (median 158.5 sec). Of the 62 insertions, 36 (58.1%) were completed within 3 min, and 58 (93.5%) within 5 min. Successful outcomes were observed in 15 (83.3%) of the 18 patients. CONCLUSIONS: EWS bronchial occlusion using a curette is a simple method for managing intractable bronchopleural fistulas in daily clinical settings.
Assuntos
Fístula Brônquica/terapia , Doenças Pleurais/terapia , Pneumotórax/terapia , Oclusão Terapêutica/métodos , Idoso , Idoso de 80 Anos ou mais , Empiema/terapia , Feminino , Hemoptise/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Elastômeros de Silicone , Oclusão Terapêutica/instrumentação , Fatores de Tempo , Resultado do TratamentoRESUMO
A prolonged air leak caused by pulmonary tuberculosis is difficult to treat, and little is known about optimal treatment strategies. We herein report the case of a 60-year-old man who demonstrated tuberculous empyema with a fistula. An air leak from a tuberculous cavity in his left upper lobe persisted for approximately 4 months; surgical repair could not be performed due to a poor physical status and undernourishment. However, the air leak was successfully treated with endobronchial occlusion using two silicone spigots in left B3b and B4, without any adverse effects or aggravation of the infection.
Assuntos
Fístula Brônquica/terapia , Broncoscopia/instrumentação , Embolização Terapêutica/instrumentação , Empiema Tuberculoso/complicações , Doenças Pleurais/terapia , Antituberculosos/uso terapêutico , Fístula Brônquica/diagnóstico por imagem , Empiema Tuberculoso/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/diagnóstico por imagem , Resultado do TratamentoRESUMO
We report the successful application of high-frequency oscillatory ventilation in a patient with tension pneumatocele (TP). The proposed check-valve mechanism for the development of pneumatoceles predicts that positive-pressure ventilation could lead to distension of these airspaces and formation of TPs. Therefore, high-frequency ventilation could be more applicable in conditions, such as massive air leak due to bronchopleural fistula, that are difficult to manage by conventional ventilator modes.
Assuntos
Cistos/terapia , Ventilação em Jatos de Alta Frequência , Pneumopatias/terapia , Pneumonia Pneumocócica/terapia , Pneumotórax/terapia , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/terapia , Tubos Torácicos , Pré-Escolar , Cistos/diagnóstico por imagem , Feminino , Fístula/diagnóstico por imagem , Fístula/terapia , Humanos , Pneumopatias/diagnóstico por imagem , Oxigênio/sangue , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/terapia , Pneumonia Pneumocócica/diagnóstico por imagem , Pneumotórax/diagnóstico por imagem , Radiografia , Resultado do TratamentoRESUMO
UNLABELLED: HISTORY AND INTERVENTION: A 52-year-old female patient underwent open abdominothoracic cardia and esophageal resection with gastric transposition because of histologically diagnosed Barrett metaplasia with "high-grade" intraepithelial neoplasia (HGIEN) and parts of an invasive adenocarcinoma. The anastomotic insufficiency on the 10th postoperative day including an esophagobronchial fistula prompted to a subsequent surgical re-intervention with suture of the fistula, lavage and additional drainage, an endoscopic stenting of the fistula from esophageal site, as well as repeated (n = 22) bronchoscopic applications of fibrin glue (1-3 ml each) into the lumen of the fistula after each bronchoscopic lavage of the fistula until the complete closure was achieved. The changeful clinical course of 77 days on the surgical ICU was characterized by secondary complications such as pneumonia, mediastinitis and respiratory insufficiency with long-term artificial respiration and creation of a percutaneous dilatation tracheotomy. CONCLUSION: The application of fibrin glue can be considered a promising, minimally invasive therapeutic option in the management of postoperative fistula after esophageal resection, which requires expertise in decision-making and the finding-specific approach, in particular, if indicated inital steps of the sequential complication management such as surgical re-intervention and conventional endoscopic measures (stenting, Endo-VAC[-sponge]) do not provide great therapeutic potential any more due to the prolonged postoperative time course and the unfavorable local findings. In the presented case, modes of an assisted artificial respiration with low pressure and short phases of apnoe after fibrin glue application were the crucial predictions for an initial and favorable adhesion of this glue and finally for a successful sealing resulting in a sufficient closure of the fistula.
Assuntos
Fístula Brônquica/terapia , Fístula Esofágica/terapia , Esofagectomia/métodos , Adesivo Tecidual de Fibrina/administração & dosagem , Técnicas de Fechamento de Ferimentos , Cicatrização/efeitos dos fármacos , Feminino , Humanos , Pessoa de Meia-Idade , Adesivos Teciduais/administração & dosagem , Resultado do TratamentoRESUMO
AIM: To study the clinical characteristics, diagnosis and surgical treatment of congenital bronchoesophageal fistulae in adults. METHODS: Eleven adult cases of congenital bronchoesophageal fistula diagnosed and treated in our hospital between May 1990 and August 2010 were reviewed. Its clinical presentations, diagnostic methods, anatomic type, treatment, and follow-up were recorded. RESULTS: Of the chief clinical presentations, nonspecific cough and sputum were found in 10 (90.9%), recurrent bouts of cough after drinking liquid food in 6 (54.6%), hemoptysis in 6 (54.6%), low fever in 4 (36.4%), and chest pain in 3 (27.3%) of the 11 cases, respectively. The duration of symptoms before diagnosis ranged 5-36.5 years. The diagnosis of congenital bronchoesophageal fistulae was established in 9 patients by barium esophagography, in 1 patient by esophagoscopy and in 1 patient by bronchoscopy, respectively. The congenital bronchoesophageal fistulae communicated with a segmental bronchus, a main bronchus, and an intermediate bronchus in 8, 2 and 1 patients, respectively. The treatment of congenital bronchoesophageal fistulae involved excision of the fistula in 10 patients or division and suturing in 1 patient. The associated lung lesion was removed in all patients. No long-term sequelae were found during the postoperative follow-up except in 1 patient with bronchial fistula who accepted reoperation before recovery. CONCLUSION: Congenital bronchoesophageal fistula is rare in adults. Its most useful diagnostic method is esophagography. It must be treated surgically as soon as the diagnosis is established.