Congenital bronchoesophageal fistula is a rare clinical entity in adults. This anomaly may cause various symptoms such as respiratory infections, coughing bouts when eating or drinking, and even hemoptysis. The fistula can cause symptoms in childhood but may not appear until adulthood. We recently experienced a case of congenital bronchoesophageal fistula associated with esophageal diverticulum in an adult. A 63-year-old woman was admitted to our hospital due to chest discomfort, sore throat and coughing bouts when eating. An empyema with lung abscess had occurred eight years previously. Results of the physical examination were unremarkable. A Barium swallowing revealed a medium-sized diverticulum at the right anterior aspect of the esophagus, which had developed a fistulous connection with the right lower lobe bronchus. The patient was treated by fistulectomy and lobectomy of the right lower lobe. The postoperative course was smooth and uneventful.
Bronchial Diseases/congenital* ; Bronchial Diseases/complications* ; Case Report ; Diverticulum, Esophageal/complications* ; Esophageal Diseases/congenital* ; Esophageal Diseases/complications* ; Female ; Fistula ; Human ; Middle Age

Bronchi ; abnormalities ; Bronchial Diseases ; congenital ; diagnosis ; Child, Preschool ; Constriction, Pathologic ; congenital ; Diagnostic Errors ; Female ; Foreign Bodies ; diagnosis ; Humans

Congenital cystic adenomatoid malformation (CCAM) is a rare congenital disorder of pulmonary development that usually presenting as a respiratory distress in the neonatal period. Presentation in adulthood is rare and only 40 cases of CCAM in adulthood have been reported in literatures. A 49-year-old woman presented with hemoptysis. Postero anterior chest radiograph showed an air-fluid level in right upper lobe. A computed tomographic (CT) scan of the chest showed multilocular thick-walled cystic lesions in right upper lobe. A CT angiography showed cystic lesions with normal bronchial artery supply in right upper lobe, which were consistent with CCAM. A complete surgical resection of the right upper lobe was performed confirming a type 2 CCAM according to the expanded Stocker's classification.
Angiography ; Bronchial Arteries ; Classification ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Female ; Hemoptysis* ; Humans ; Lung* ; Middle Aged* ; Radiography, Thoracic ; Thorax

BACKGROUND: Although congenital anomalies of the coronary arteries are rare, which may cause serious clinical problems in diagnostic or surgical procedures, the accurate knowlegde and understanding of these are essential. We are to assess the clinical and angiographic characteristics of congenital anomalies of the coronary arteries detected in adulthhood. METHODS: We retrospectively analyzed a total of 67 cases of primary congenital anomalies of the coronary arteries with particular emphasis in angiographic findings in corelation with the clinical and surgical findings, reviewing 16,099 coronary angiography performed during last 6 years in three institutes. RESULTS: The incidence of congenital anomalies of the coronary arteries detected in coronary angiography was 0.4% and all were primary anomalies, among which major anomalies were 53 cases(79%) and minor anomalies were 14 cases(21%). Twenty-nine cases had associated cardiac defects. Among them congenital heart disease were 10 cases(34%), valvular heart disease were 10 cases(34%), coronary atherosclerotic disease were 8 cases(28%) and hypertrophic obstructive cardiomyopathy was 1 cases(4%). The coronary artery fistula were 40 cases, which was the most common anomaly among major group and the communication between coronary artery and bronchial artery were 6 cases, which was the most common one among minor group. Myocardial ischemia was observed in 49% of major and in 29% of minor anomalies. CONCLUSION: We are reporting 67 cases of the congenital anomalies of the coronary arteries detected in adulthood with the clinical and the angiographic characteristics. We suggest that new modified classification of the congenital coronary anomalies is necessary, because symptoms and signs of myocardial ischemia were observed in a significant number of patients among minoranomaly group.
Academies and Institutes ; Bronchial Arteries ; Cardiomyopathy, Hypertrophic ; Classification ; Coronary Angiography ; Coronary Vessels* ; Fistula ; Heart Defects, Congenital ; Heart Valve Diseases ; Humans ; Incidence ; Myocardial Ischemia ; Retrospective Studies

Bronchi ; abnormalities ; pathology ; Bronchial Diseases ; complications ; congenital ; diagnosis ; pathology ; Bronchoscopy ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Infant ; Male ; Pneumonia ; etiology ; physiopathology ; Respiratory System Abnormalities ; complications ; diagnosis ; pathology ; Trachea ; abnormalities ; pathology ; Tracheal Stenosis ; etiology ; pathology