Broncho-esophageal fistula

A bronch-esophageal fistula (BOF) refers to an abnormal communication between a bronchus and the esophagus.

For congenital fistulas, please refer to the article on congenital tracheo-esophageal fistula.

Clinical presentation

A small proportion of patient with congenital forms may present in adulthood. A common presenting feature is with recurrent pulmonary infections with other uncommon presentations being recurrent coughing bouts with meals and rarely hemoptysis.

Pathology

Etiology

A broncho-esophageal fistula can be either congenital or acquired, with the latter including:

• esophageal cancer: can complicate 5-15% of cases
• percutaneous endoscopic gastronomy (rare) 
• complication of acute radiation-induced esophagitis
• infective etiology affecting the esophagus
  • esophageal tuberculosis
  • esophageal syphilis
  • esophageal histoplasmosis
  • esophageal actinomycosis
  • esophageal candidiasis

Treatment and prognosis

Complications

• recurrent pulmonary infection and sepsis

See also

• tracheo-esophageal fistula
• bronchopleural fistula