Abstract
We report a bronchoesophageal fistula that treat with bronchial stent insertion and histoacryl injection. A 52-year-old man with esophagel cancer was transferred for dysphagia management. At the CT scan that underwent on admission, esophageal cancer with multiple lymph node metastasis was observed. At the gastroduodenoscopy and contrast study, bronchoesophageal fistula was observed. Recurrent stent insertion treatment was failed, and then, By the broncoscopy, covered stent was inserted to right bronchus, and By the endoscopy, fibrin glue and histoacryl was injected in the fistula opening. At the contrast study, contrast leakage was not observed, and the patient was discharged. But, at the 14 days after discharge, the patient was admitted to the emerency room because of cough symptom whenever he eat food. The patient was diagnosed with aspiration pneumonia, we were determined that it is unable to oral intake. The patient received a jejunostomy and antibiotic treatment for aspiration pneumonia. He was discharged after symptomatic improvement.
식도암으로 인한 기관지 식도 누공 환자는 음식물을 섭취하면 누공을 통하여 기관지로 음식물이 흡입되어 폐렴과 같은 합병증을 유발할 수 있다. 특히 전신쇠약이 동반되고 면역력이 저하되어 있는 식도암 환자에게는 치명적인 결과를 초래할 수 있다. 기관지 식도 누공의 내시경적 치료는 환자에게 경구 섭취를 가능하게 하고, 합병증의 발생을 예방할 수 있을 것으로 생각된다. 하지만 아직까지 장기간의 효과 지속성이나 재발에 관하여는 만족스러운 결과가 없는 실정이다. 향후 새로운 내시경 치료법의 개발 및 치료 효과에 대한 연구가 필요하다고 생각한다.