CTICasesEsophagobronchial Fistula
Imaging findings
Chest CT and subsequent esophagram in a patient with a history of esophageal stenting show a fistula arising from the proximal margin of the esophageal stent and communicating with the right pleural space and lower lobe bronchial tree. This is associated with extensive right lower lobe necrotizing consolidation, complex pleural effusion/empyema, and leakage of oral contrast medium directly into the lung parenchyma.
Key takeaways
Esophagobronchial or esophagopleural fistula is a serious, life-threatening complication of esophageal stenting or malignancy. On CT, it presents as extraluminal air and fluid tracking into the pleura or lung. Contrast-enhanced CT or a water-soluble esophagram is diagnostic in directly demonstrating extravasation of contrast into the pleural space or bronchial tree, causing severe necrotizing pneumonia.
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