Congenital broncho-esophageal fistula in the adult

The case of a 62-year-old woman with a type II congenital broncho-esophagea l fistula is presented. She had had recurrent pulmonary infections that wer e more prominent in the last 15 years. A barium swallow examination showed a communication between the esophagus and the right lower lobe. High resolu tion computed tomographic scan of the chest revealed right middle and lower lobe bronchiectasis. Bronchoscopy was unremarkable. At thoracotomy broncho esophageal fistula was divided and the esophageal end was repaired in two l ayered fashion and reinforced by pediculed parietal pleural flap. Right mid dle and lower lobectomies were performed. Demonstration of the broncho-esop hageal fistula and assessment of the status of the pulmonary parenchyma are important steps prior to surgery.