A case of an acquired esophago bronchial fistula successfully treated by endoscopic laser coagulation therapy

A 64-year old man, who had had repeated mediastinitis due to esophageal fistula, was transferred to our hospital for the further examination and therapy. His chest X-ray and CT scan on admission showed pneumonia and thickened wall of the lower esophagus. Esophagogram revealed a fistula with a diameter of about 1 mm on the left wall. Esophagoscopy showed air leaking through the orifice of the fistula. A diagnosis of an acquired esophago-bronchial fisutula was made. We performed the endoscopic laser coagulation to close the fistula using Nd YAG laser. Two months after the treatment, either esophagogram or esophagoscopy demonstrated no evidence of fistula. There was no complication in the course of the treatment. Pneumonia or mediastinitis has not occured for 4 years after the treatment. Our experience suggests that Nd-YAG laser therapy is a safe and effective treatment for acquired esophageal fisutula.