Case of bronchoesophageal fistula with gastric perforation due to multidrug-resistant tuberculosis

Abstract

Gastric perforation and tuberculous bronchoesophageal fistula (TBEF) are very rare complications of extra pulmonary tuberculosis (TB). We present a case of pulmonary TB with TBEF and gastric perforation caused by a multidrugresistant tuberculosis strain in a non acquired immune deficiency syndrome male patient. The patient underwent total gastrectomy with Roux enY endtoside esophagojejunostomy and feeding jejunostomy during intravenous treatment with antiTB medication, and esophageal reconstruction with colonic interposition and jejunocolostomy were performed successfully after a full course of antiTB medication. Though recent therapies for TBEF have favored medication, patients with severe stenosis or perforation require surgery and medication with antiTB drugs based upon adequate culture and drug susceptibility testing.

Esophago-pulmonary fistula manifesting as recurrent pneumonias and migrating mediastinal calcifications

“…It could be a complication of toxic ingestions or achalasia [3]. Fistula formation may also follow mediastinal infection (particularly granulomatous), malignancy, chemotherapy, trauma, thoracic surgery or lung transplantation [4][5][6][7]. Mediastinal lymph node calcifications are often the result of the healing process of an inflammatory condition affecting the mediastinum.…”