Congenital aerodigestive fistula with extraordinarily delayed adult presentation: a case report and review of endoscopic closure for bronchoesophageal fistula - Report - MDSpire
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Congenital aerodigestive fistula with extraordinarily delayed adult presentation: a case report and review of endoscopic closure for bronchoesophageal fistula
Clinical Report: Adult Presentation of Congenital Aerodigestive Fistula
Background
Congenital aerodigestive fistulae (ADF) are rare malformations that can lead to significant morbidity if undiagnosed. While typically identified in neonates, isolated BEF may remain asymptomatic until adulthood, complicating diagnosis and management. Understanding the presentation and treatment options for adult cases is crucial.
Data Highlights
No numerical or trial data available.
Key Findings
The patient presented with a 40-year history of swallowing-induced cough and mucoid sputum.
Initial imaging suggested a lung mass, but bronchoscopy revealed an esophageal-left main bronchial fistula.
Endoscopic closure using argon plasma coagulation and over-the-scope clip was successful.
At 10-month follow-up, imaging confirmed no persistent fistulous communication.
Congenital BEF can present in adulthood with chronic symptoms, necessitating a high index of suspicion.
Clinical Implications
Endoscopic techniques such as de-epithelialization and OTSC deployment may provide management options for congenital BEF, particularly in patients who are not surgical candidates.
Conclusion
This case illustrates the delayed presentation of congenital BEF. More clinical studies are warranted to develop consensus-based guidelines for the management of benign ADF.
