An esophagorespiratory fistula (ERF) is an often fatal consequence of esophageal or bronchogenic carcinomas. The preferred treatment is placement of esophageal and/or airway stents. Stent placement must be performed as quickly as possible since patients with ERFs are at a high risk for aspiration pneumonia. In this review, choice of stents and stenting area, fistula reopening and its management, and the long-term outcome in the interventional management of malignant ERFs are considered. Lastly, a review of esophagopulmonary fistulas will also be provided.
Bronchial Neoplasms/*complications ; Esophageal Fistula/etiology/*therapy ; Esophageal Neoplasms/*complications ; Esophagus/surgery ; Humans ; Palliative Care/methods ; Quality of Life ; Respiratory System/surgery ; Respiratory Tract Fistula/etiology/*therapy ; *Stents ; Treatment Outcome

Children who underwent reparative operations for esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), are confronted with many gastrointestinal or respiratory problems, especially during the early years of life. We reviewed the medical records of 50 patients who underwent repairs of EA with or without TEF at the Division of Pediatric Surgery, Samsung Medical Center, from December 1994 to December 2005. Current status of children was accessed by telephone-interview, but only 27 of them were accessible. Of 50 patients, 3 patients (6%) were type A, 45 patients (90%) were type C, and 2 patients (4%) were type E. The mean interval between primary operation and interview was 5.5 years. The incidences of growth retardation (<10 percentile of height/weight) were 39% and 21 % during the first 5 years after repairs, respectively. The incidences of dysphagia or gastroesophageal reflux and recurrent respiratory infections were 33% and 39 %, respectively. However, these problems were likely to improve as the children grew. The incidences of growth retardations (<10 percentile of height/weight) were 11% and 11% for the children more than five years postoperative. The incidences of dysphagia or gastroesophageal reflux and recurrent respiratory infections were 22% and 22%, respectively. Children with EA with or without TEF are faced with many obstacles. Close observation and adequate treatment for delayed postoperative complications are necessary to improve the quality of life for these children.
Child ; Deglutition Disorders ; Esophageal Atresia ; Gastroesophageal Reflux ; Humans ; Incidence ; Medical Records ; Postoperative Complications ; Quality of Life ; Respiratory Tract Infections ; Tracheoesophageal Fistula

Left pulmonary artery agenesis, accompanied by a coronary arterial fistula, is a very rare anomaly. Although unilateral pulmonary artery agenesis is associated with other cardiovascular defects, like as ventricular septal defect, patent ductus arteriosus, and tetralogy of fallot, this anomaly, accompanied by a coronary arterial fistula, has not yet been reported. Most patients with no associated cardiac anomalies have only minor, or absent, symptoms, and survive to adulthood, but some patients may suffer from recurrent respiratory infections and hemoptysis. The vessel to the affected lung in many of the proved cases has been described as arising from either the bronchial artery or the aortic arch. The blood supply from the coronary artery to the affected lung has never been reported. Recently, a case of left pulmonary artery agenesis, accompanied with a coronary arterial fistula was experienced, which was diagnosed by coronary angiography and a chest CT, which is presented, with the review of relevant literature.
Aorta, Thoracic ; Arteries* ; Bronchial Arteries* ; Coronary Angiography ; Coronary Vessels ; Ductus Arteriosus, Patent ; Fistula* ; Heart Septal Defects, Ventricular ; Hemoptysis ; Humans ; Lung ; Pulmonary Artery* ; Respiratory Tract Infections ; Tetralogy of Fallot ; Tomography, X-Ray Computed

Congenital bronchoesophageal fistula is a rare anomaly that may cause fatal complications if it goes unnoticed for many years. This anomaly may have various symptoms such as respiratory infections, coughing bouts when eating or drinking and even hemoptysis. Surgical resection is the treatment of choice and is definitive in almost cases. We report a case of type I congenital bronchoesophageal fistula misdiagnosed as chronic empyema thoracis with literature review.
Cough ; Drinking ; Eating ; Empyema* ; Fistula* ; Hemoptysis ; Respiratory Tract Infections

Congenital bronchoesophageal fistula is a rare anomaly that may cause fatal complications if it goes unnoticed for many years. This anomaly may have various symptoms such as respiratory infections, coughing bouts when eating or drinking and even hemoptysis. Surgical resection is the treatment of choice and is definitive in almost cases. We report a case of type I congenital bronchoesophageal fistula misdiagnosed as chronic empyema thoracis with literature review.
Cough ; Drinking ; Eating ; Empyema* ; Fistula* ; Hemoptysis ; Respiratory Tract Infections

Pulmonary mucormycosis is an uncommon opportunistic fungal infection associated with diabetes mellitus, leukemia, lymphoma, and other debilitating diseases. It is diagnosed by the pathologic demonstration of typical hyphae, and the condition requires aggressive surgical treatment to reduce the risk of mortality. Pulmonary mucormycosis is associated with various clinical and radiological characteristics. Therefore, a rapid diagnosis and aggressive surgical approach based on early suspicion are important in high-risk patients in order to cure pulmonary mucormycosis. Here, we report the successful treatment of pulmonary mucormycosis in a 58-year-old male with glottic cancer and uncontrolled diabetes who had rapidly progressive necrotizing pneumonia and a bronchopleural fistula via an aggressive pathologic diagnosis and surgical resection.
Diabetes Mellitus ; Fistula ; Humans ; Hyphae ; Leukemia ; Lymphoma ; Male ; Middle Aged ; Mucormycosis ; Pneumonectomy ; Pneumonia ; Respiratory Tract Fistula

Malformation of the anus and rectum, frequently refered to as imperforate anus are the most common of congenital anomalies among the congenital anomalies of gastrointestinal tract, occuring about once in every 5,000births. They consist of variety of lesions ranging from mild congenital stenosis of the anus which requires simple dilation for cure to complex deformities which present some of the most vexing and discouraging problem in management. This is the report of clinical analysis and evaluation of 67 patients with congenital anorectal malformation, experienced at Severance Hospital, during past 15 years form Jan. 1963 to Dec. 1978. The results of observation were as follows: 1. Incidence of observation were as follows: 2. There were 47 males and 18 females and 2 cases of unknown sex, than male/female ratio was 2.6 : 1. 3. First and second born were more commonly observed than the others. 4. High anomalies were 37.3%, intermediate anomales were 11.9% and low anomalies were 46.3%. 5. Associated anomalies were noted in 12 out of 67 cases, which consist of congenital heart diseases, skeletal anomalies, single umbillical artery, congenital megacolon etc. 6. In general, perineal anoplasty with or without preliminary colostomy were performed in low anomalies and some cases of intermediate anomalies. And abdominoperineal pull-through operation with or without preliminary colostomy were done in high anomales. 7. Complication after surgery were main wound infection ad disruption, intestinal obstruction, fecal incontinence, urinary incontinence, vaginal perforation, and urethral injury etc. 8. Overall mortality was 19.4% and operative mortality was 9.4%. 9. Factors influencing on mortality were congenital heart diseases, sepsis, prematurity, multiple congenital anomalies, respiratory insufficiency, meningomyelocele and tracheoesophageal fistula.
Anal Canal ; Anus, Imperforate ; Arteries ; Colostomy ; Congenital Abnormalities ; Constriction, Pathologic ; Fecal Incontinence ; Female ; Gastrointestinal Tract ; Heart Diseases ; Hirschsprung Disease ; Humans ; Incidence ; Intestinal Obstruction ; Male ; Meningomyelocele ; Mortality ; Rectum ; Respiratory Insufficiency ; Sepsis ; Tracheoesophageal Fistula ; Urinary Incontinence ; Wound Infection

Humans ; Male ; Middle Aged ; Polypropylenes ; Reconstructive Surgical Procedures ; Respiratory Tract Fistula ; surgery ; Surgical Mesh

The tracheocutaneous fistula after tracheostomy is a complex clinical problem. An ideal fistula closure is still difficult at present though a variety of fistula-closing methods have been reported in the literature. We used a turnover skin flap to cover the fistula. All the procedures were completed at bedside under local anesthesia. The fistula was successfully closed and well healed without complications within 7-9 days. It has been proven that this operation is simple, effective, and safe.
Aged ; Aged, 80 and over ; Cutaneous Fistula ; etiology ; surgery ; Female ; Humans ; Male ; Postoperative Complications ; surgery ; Respiratory Tract Fistula ; etiology ; surgery ; Surgical Flaps ; Tracheal Diseases ; etiology ; surgery ; Tracheotomy ; adverse effects

Communicating bronchopulmonary foregut malformation (CBPFM) is a communication between the respiratory and gastrointestinal tracts that can be difficult to differentiate from pulmonary sequestration or H-type tracheoesophageal fistula (TEF) because of the similarities in clinical features. A female neonate born at full term had been experiencing respiratory difficulty during feeding from the third day of life. The esophagography performed to rule out H-type TEF revealed that the esophageal bronchus directly communicated with the left lower lobe (LLL) of the lung. Lobectomy of the LLL, fistulectomy of the esophagobronchial fistula, and primary repair of the esophagus were performed. Finally, CBPFM type III with pulmonary sequestration was confirmed on the basis of the postoperative histopathological finding. We report the first newborn case of CBPFM type III with pulmonary sequestration in Korea.
Bronchi ; Bronchial Fistula ; Bronchopulmonary Sequestration ; Esophagus ; Female ; Fistula ; Gastrointestinal Tract ; Humans ; Infant, Newborn ; Korea ; Lung ; Tracheoesophageal Fistula