Perforating Barrett’s ulcer resulting in a life-threatening esophagobronchial fistula John J Nigro, MD, MS, Ross M Bremner, MD, PhD, Clark B Fuller, MD,

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Presentation transcript:

Perforating Barrett’s ulcer resulting in a life-threatening esophagobronchial fistula John J Nigro, MD, MS, Ross M Bremner, MD, PhD, Clark B Fuller, MD, Jörg Theisen, MD, Yanling Ma, MD, Vaughn A Starnes, MD The Annals of Thoracic Surgery Volume 73, Issue 1, Pages 302-304 (January 2002) DOI: 10.1016/S0003-4975(01)02757-6

Fig 1 Soft tissue windows of the chest computed tomographic scan. The esophagobronchial fistula is marked with arrow A. Arrow B identifies the air-filled and dilated esophagus. The Annals of Thoracic Surgery 2002 73, 302-304DOI: (10.1016/S0003-4975(01)02757-6)

Fig 2 Endoscopic view of the distal esophagus, the large black arrow points to the fistula between the esophagus and the left mainstem bronchus. The picture on the right shows both the fistula and the esophageal lumen. Endoscopic Barrett’s changes are evident in both photographs. The Annals of Thoracic Surgery 2002 73, 302-304DOI: (10.1016/S0003-4975(01)02757-6)

Fig 3 Resected esophagus that has been incised longitudinally, exposing the mucosal surface. The distal esophagus is marked with “D” and the fistula site is marked with “F.” The white mucosa at the superior aspect of the esophagus is squamous mucosa, the area adjacent to the fistula has severe mucosal damage, and the distal esophagus has salmon pink mucosa characteristic of Barrett’s esophagus. The Annals of Thoracic Surgery 2002 73, 302-304DOI: (10.1016/S0003-4975(01)02757-6)

Fig 4 Sections from the resected esophagus that have been stained with hemotoxilyn and eosin. (A) Section of esophageal wall at the fistula site that contains inflammation, fibrosis, and erosion. (B) Esophageal mucosa adjacent to the fistula. It contains intestinal metaplasia with goblet cells (Barrett’s esophagus). The Annals of Thoracic Surgery 2002 73, 302-304DOI: (10.1016/S0003-4975(01)02757-6)