Oesophago-pleural fistula associated with pulmonary tuberculosis

• Autor(a) principal: Silva Júnior, Geraldo B.
• Data de Publicação: 2008
• Outros Autores: Lima Verde, Raquel C., C. C. Muniz, Marco António, M. Cavalcante, António jorge, M. R. Lima, Alexandre, Gomes Neto, Antero
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1486
• topic: Fístula esôfago-pleural; perfuração esofágica; tuberculose; Oesophago-pleural fistula; tuberculosis; oesophageal perforation

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.