CTICasesEsophagospinal-Parenchymal Fistula
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Imaging findings
Chest computed tomography reveals multiple bilateral lung abscesses and areas of extensive necrotic pulmonary parenchyma. There is direct, complex communication and fluid tracking between the esophagus, the thoracic spinal canal at the site of prior spinal surgery, and the adjacent necrotic right lung parenchyma, representing a severe esophagospinal-parenchymal fistula.
Key takeaways
Fistulas simultaneously communicating between the esophagus, the spinal canal, and the lung parenchyma are exceptionally rare and highly morbid complications of spinal or esophageal interventions. They present with rapidly progressive pulmonary necrosis and severe sepsis, carry an extremely poor clinical prognosis, and require prompt, highly complex multidisciplinary management.
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