A bronchoesophageal fistula (BEF) is an uncommon diagnosis that may be congenital or acquired. In 1697, Thomas Gibson was first to report a case of an infant with congenital esophageal atresia and a tracheoesophageal fistula (TEF). Primary esophageal cancers[1,2] are the most common cause of an acquired BEF. Other causes of acquired BEF include cuff-related trauma secondary to endotracheal intubation, infections such as pulmonary tuberculosis and, less commonly, ulcerations from Barrett's esophagus.[1,3] Patients typically present with nonspecific symptoms, including cough, abdominal pain, hemoptysis, and recurrent respiratory tract infections.[3,4]
The first successful surgical repair was performed by Cameron Haight in 1941. With advancement of technique since that time, surgery is now usually curative. Endoscopic surgical techniques have yet to be developed. Anatomic correction of the fistula prevents chronic complications, such as persistent aspiration, pulmonary sepsis, and even death.
The authors present a case of acquired BEF in a man with a history of self-induced vomiting.
Medscape Gastroenterology © 2011
Cite this: Andrew Korman, Maria F. Kassab, Lan S. Wang, et. al. Bronchoesophageal Fistula From Self-Induced Vomiting - Medscape - May 25, 2011.