When less is more: a daring conservative approach to postpneumonectomy oesophago-pleural fistula

Interact Cardiovasc Thorac Surg. 2020 Jan 1;30(1):146-148. doi: 10.1093/icvts/ivz240.

Abstract

Oesophago-pleural fistula is an uncommon complication after pneumonectomy, usually related to high morbidity and mortality. Due to its rarity and heterogeneous clinical presentation, its diagnosis and management are challenging issues. Here, we report the case of a patient with a history of pneumonectomy for a tracheal tumour, who developed an asymptomatic oesophago-pleural fistula 7 years after primary surgery. In consideration of the patient's good clinical status and after verifying the preservation of respiratory and digestive functions, a bold conservative approach was adopted. Five-year follow-up computed tomography did not disclose any sign of recurrence of disease and showed a stable, chronic fistula.

Keywords: Conservative approach; Oesophago-pleural fistula.

Publication types

  • Case Reports

MeSH terms

  • Bronchoscopy
  • Conservative Treatment / methods*
  • Esophageal Fistula / diagnosis
  • Esophageal Fistula / etiology
  • Esophageal Fistula / therapy*
  • Female
  • Fistula / diagnosis
  • Fistula / etiology
  • Fistula / therapy
  • Humans
  • Middle Aged
  • Pleural Diseases / diagnosis
  • Pleural Diseases / etiology
  • Pleural Diseases / therapy*
  • Pneumonectomy / adverse effects*
  • Tomography, X-Ray Computed
  • Tracheal Neoplasms / diagnosis
  • Tracheal Neoplasms / surgery