Oesophago-pleural fistula associated with pulmonary tuberculosis
Keywords:
Oesophago-pleural fistula, tuberculosis, oesophageal perforationAbstract
The authors present a clinical case report of oesophago-pleural
fistula in a 36 year-old patient with a history of pulmonary
tuberculosis. The patient was admitted with a history of cough,
purulent sputum and haemoptysis, associated with fever, pleuritic
pain and post-prandial vomiting. He complained of cough and a
sensation of weight in his right hemi-thorax after eating. He had
a 40 day hospital stay and pleurostomy was performed. Whilst in
hospital drainage of food through the pleurostomy was observed.
The patient was re-admitted for investigation of an oesophago-pleural fistula. On admission he appeared healthy. Pulmonary
auscultation revealed decreased breath sounds, with wheezes
and crackles. He had digital clubbing. The chest x-ray showed
a right lung with tuberculosis sequelae and a compensatory
hyperinflated left lung. Chest CT scan showed a reduced right
lung, with pulmonary collapse of the inferior lobe, bronchiectasis, fibrosis and emphysematous lesions in the left lung apex. A
dilated oesophagus was seen, with fistular communication with
the pleural cavity, as shown by contrast. Upper G.I. endoscopy
confirmed the presence of an oesophageal fistula in the proximal
portion. The patient was submitted to pleuropneumonectomy and
oesophageal fistula correction.
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