Benign Broncho-oesophageal Fistula in an Adult

Abstract

Presentation
We describe the case of an elderly lady who was diagnosed with a BOF after presenting in type 1 respiratory failure, with no risk factors or malignancy. A history of recurrent pneumonia with multi-drug resistant pathogens led to radiological investigation into an abnormal connection between the GI and respiratory tracts.

Diagnosis
A fluoroscopic barium swallow study is the radiological investigation of choice. Our case illustrates that CT may also be useful in identifying and characterizing a BOF but requires a high index of suspicion as they are usually subtle.

Treatment
A non-surgical approach was employed due to the frailty of this patient. An excellent outcome was achieved, with full resolution of symptoms and prevention of further complications.

Discussion
There are few cases described of benign broncho-oesophageal Fistulas (BOF) in adults. Greater than fifty per cent of cases are caused by oesophageal or lung malignancies. The majority of benign cases are iatrogenic.