Özofagoplevral veya özofagotrakeal fistül

Özet

Özofagoplevral veya özofagotrakeal fistül, özofagus lümeniyle plevra ya da trakeobronşiyal ağaç arasında anormal ileti oluşmasıdır; cerrahi, tümör, enfeksiyon, travma veya girişim sonrası gelişebilir. İnce kesitli kontrastlı BT, doğrudan traktı gösterebilir ve mediastinal, plevral ya da pulmoner yayılımı haritalar. Ağızdan verilen suda çözünen kontrastın plevraya kaçması doğrudan özofagoplevral iletiyi kanıtlar; hava yolu fistüllerinde küçük trakt yanında aspirasyon bulguları görülebilir. Fistülün atlanması plevral kontaminasyon, mediastinit ve tekrarlayan aspirasyonun kaynağını gizleyebilir.

Faz ve pencere

Portal tanısal

İnce kesitlerde özofagus duvarındaki defekt/trakt, komşu trakea-bronş ya da plevral koleksiyonla ileti, ekstraluminal hava ve çevresel inflamasyon araştırılır; ağızdan verilmiş suda çözünen kontrast varsa lümen dışına ve plevraya geçiş izlenir.

Kontrastsız

Mediastinal hava, plevral hava-sıvı, loküle efüzyon ve aspirasyon opasiteleri görülebilir; ince fistül traktı veya aktif kontrast kaçağı kontrastsız incelemede dışlanamaz.

Önerilen pencereler: Mediasten (G 350 / M 50), Akciğer (G 1500 / M -600).

BT bulguları

• Özofagus ile plevra arasında doğrudan trakt — duvar defektinden plevral koleksiyona uzanan hava/kontrast içeren ileti.
• Özofagus duvarından trakea veya ana bronşa uzanan açıklık — iki lümen arasında seçilebilen ince yumuşak doku/hava traktı.
• Plevral boşlukta oral kontrast — uygun klinik ve inceleme koşullarında özofagoplevral fistül için doğrudan bulgu.
• Hidropnömotoraks veya loküle plevral sıvı — plevral kontaminasyon, enfeksiyon ya da fistülün eşlikçisi olabilir.
• Özofagus duvarında fokal kalınlaşma, balonlaşma veya incelme — perforasyon/fistül düzeyinde duvar bozulması.
• Mediastinal yağ dokusunda kirlenme ve ekstraluminal hava — perforasyonun çevre dokulara yayılımını gösterir.
• Özofago-hava yolu fistülünde aspirasyon veya başka pnömoni bulguları eşlik edebilir.
• Komşu tümör, cerrahi anastomoz veya işlem yatağı — fistülün olası etiyolojik odağını ve anatomik bağlamını belirtir.

Normalde

Normalde özofagus duvarı trakea ve ana bronşlardan ayrıdır; plevral boşlukta hava ya da oral kontrast bulunmaz ve mediastinal yağ planları korunur. Şüpheli düzeyde özofagus lümenini komşu hava yolu/plevraya kesit kesit izleyin; doğrudan bağlantı, duvar defekti ve çevresel enfeksiyon bulgularını karşı taraf ve komşu seviyelerle kıyaslayın.

Ayırıcı tanı

Özofagus perforasyonu

mediastinal hava ve duvar defekti olabilir, fakat plevra/hava yoluna devamlı bir fistül traktı gösterilmeyebilir.

Bronkoplevral fistül

bronş veya kavite ile plevra arasında ileti vardır; özofagusla bağlantı aranmaz.

Ampiyem özofagoplevral fistülle birlikte görülebilir; fistülü doğrudan göstermek için özofagustan plevraya uzanan trakt veya oral kontrastın plevral boşluğa geçişi aranır. Oral kontrastın plevral boşlukta görülmesi özofagoplevral fistül için patognomonik bir bulgudur.

Aspirasyon pnömonisi

özofago-hava yolu fistülünde aspirasyon veya başka pnömoni bulguları eşlik edebilir; doğrudan fistül bağlantısı ayrıca gösterilmelidir.

Tümör invazyonu

özofagus kitlesi komşu yapıları sarabilir; hava/kontrast içeren açık lümenler arası geçiş fistül lehinedir.

Tuzaklar

• Fistül traktı çok ince olup tek aksiyel kesitte kaybolabilir; ince kesitli koronal ve sagittal rekonstrüksiyonlarda özofagus duvarını komşu hedefe kadar izleyin.
• Plevral hava veya sıvı tek başına fistül kanıtı değildir; özofagus duvar defekti, olası ileti ve klinik işlem/cerrahi öyküsüyle ilişki kurun.
• Oral kontrast verilmemiş BT'de kontrast ekstravazasyonunun görülmemesi fistülü dışlamaz; indirekt mediastinal ve plevral bulguları da araştırın.
• İntübasyon tüpü kafı veya postoperatif anastomoz çevresindeki hava beklenen anatomiyle karışabilir; tüp ve cerrahi hattın seviyesini, komşu lümenlerle gerçek bağlantıyı doğrulayın.
• Oral kontrastlı özofagografide fistülün gösterilememesi fistülü dışlamaz; BT, özofagografide gösterilemeyen bazı özofago-hava yolu fistüllerini saptayabilir ve özofagoplevral fistül traktını gösterebilir.

Kendini dene

1. Özofagus perforasyonu sonrası sağ plevral koleksiyonda ağızdan verilen suda çözünen kontrast görülüyor. En uygun tanı nedir?

   • Özofagoplevral fistül
   • Bronkoplevral fistül
   • Ampiyem
   • Aspirasyon pnömonisi
   Cevabı göster

   Özofagoplevral fistül. Oral kontrastın plevral boşluğa ulaşması özofagoplevral iletiyi doğrudan gösterir. Bronkoplevral fistül bronşu plevraya bağlar; ampiyem plevral enfeksiyondur; aspirasyon pnömonisi akciğer parankim opasiteleri oluşturur.

2. Orta özofagus ile sol ana bronş arasında doğrudan trakt görülmesi en çok hangi tanıyla uyumludur?

   • Bronkoözofageal fistül
   • Özofago-trakeal fistül
   • Pulmoner apse
   • Konjenital pulmoner adenomatöz malformasyon
   Cevabı göster

   Bronkoözofageal fistül. Özofagus ile sol ana bronş arasındaki doğrudan trakt bronkoözofageal fistül ile uyumludur.

Kaynaklar

Bu sayfadaki 38 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 6 cümle bu karşılaştırmada düzeltildi (2026-10-09).

1. Spontaneous esophageal-pleural fistulapmc.ncbi.nlm.nih.gov
2. Laryngo-tracheo-oesophageal clefts.pubmed.ncbi.nlm.nih.gov
3. Descending necrotizing mediastinitis.pubmed.ncbi.nlm.nih.gov
4. Current Concepts - Congenital Scoliosis.pubmed.ncbi.nlm.nih.gov
5. Surgical Management of Benign Acquired Tracheoesophageal Fistulas: A Ten-Year Experience.pubmed.ncbi.nlm.nih.gov
6. Primary repair: damage control surgery in esophageal trauma.pubmed.ncbi.nlm.nih.gov
7. [Esophageal perforation].pubmed.ncbi.nlm.nih.gov
8. Caustic ingestion: CT findings of esophageal injuries and thoracic complications.pubmed.ncbi.nlm.nih.gov
9. An Interesting Case of Dysphagia in a HIV Patient.pubmed.ncbi.nlm.nih.gov
10. An Update on Diagnosis of Tracheomalacia in Children.pubmed.ncbi.nlm.nih.gov
11. A decade of non-cystic fibrosis bronchiectasis 1996-2006.pubmed.ncbi.nlm.nih.gov
12. Multidisciplinary approach to paediatric aerodigestive disorders: A single-centre longitudinal observational study.pubmed.ncbi.nlm.nih.gov
13. The multi-disciplinary management of complex congenital and acquired tracheo-oesophageal fistulae.pubmed.ncbi.nlm.nih.gov
14. Treatment of Traumatic Esophagopleural Fistula Using the Over-the-Scope-Clip System.pubmed.ncbi.nlm.nih.gov
15. Superior mesenteric vein occlusion causing severe gastrointestinal haemorrhage in two paediatric cases.pubmed.ncbi.nlm.nih.gov
16. Short‑ and long‑term prognostic factors of non‑neoplastic esophageal fistula: a retrospective study of 100 patients.pubmed.ncbi.nlm.nih.gov
17. Esophageal emergencies: another important cause of acute chest pain.pubmed.ncbi.nlm.nih.gov
18. Pediatric esophagopleural fistula: Two case reports and a literature review.pubmed.ncbi.nlm.nih.gov
19. Computed tomography and barium swallow findings of esophageal squamous cell carcinoma with suspected bronchoesophageal fistula in a patient with chronic graft-versus-host disease: A case report.pubmed.ncbi.nlm.nih.gov
20. Delayed Constrictive Pericarditis Following Presumed Esophagopericardial Communication After Esophageal Stenting.pubmed.ncbi.nlm.nih.gov
21. Thoracic Mycotic Aortic Aneurysm with Aortoesophageal Fistula and Uniformly Fatal Outcomes, a Case Series and Focused Literature Review.pubmed.ncbi.nlm.nih.gov
22. CT oral contrast and contemporary imaging pathways for suspected oesophageal perforation in the emergency department: a retrospective observational study.pubmed.ncbi.nlm.nih.gov
23. Esophageal Perforation During Dilation in a Patient With Hypopharyngeal Metastatic Squamous Cell Carcinoma.pubmed.ncbi.nlm.nih.gov
24. Successful multistage surgical management of Boerhaave syndrome: a case report and review of the literature.pubmed.ncbi.nlm.nih.gov
25. Foreign body ingestions in children and adolescents: A position paper of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) endoscopy special interest group.pubmed.ncbi.nlm.nih.gov
26. Esophageal Perforation Caused by an Ingested Fish Bone Leading to Aortic Pseudoaneurysm: A Rare Vascular Complication in a 54-Year-Old Patient.pubmed.ncbi.nlm.nih.gov
27. The forgotten airway: central airway pathology in the ICU.pubmed.ncbi.nlm.nih.gov
28. Congenital aerodigestive fistula with extraordinarily delayed adult presentation: a case report and review of endoscopic closure for bronchoesophageal fistula.pubmed.ncbi.nlm.nih.gov
29. Case Report: Aortoesophageal fistula after radical gastrectomy for cardia cancer: diagnostic problems and successful staged treatment.pubmed.ncbi.nlm.nih.gov
30. Boerhaave's syndrome associated with glucagon-like peptide-1 receptor agonist use: a case report.pubmed.ncbi.nlm.nih.gov
31. A rare case of esophageal perforation following a choking episode with complicated course: management and outcomes.pubmed.ncbi.nlm.nih.gov
32. Chronic cough suspected as pneumothorax and identified as esophago-pleural fistula.pubmed.ncbi.nlm.nih.gov
33. From Migration to Emergency: A Systematic Review of Acute Presentations Following Late Esophageal Stent Migration.pubmed.ncbi.nlm.nih.gov
34. Respiratory Morbidity After Repair of Type C Esophageal Atresia with Tracheoesophageal Fistula: A Pediatric Case Series.pubmed.ncbi.nlm.nih.gov
35. Bulbar "Red Flag" Symptoms and a 21-Year Diagnostic Delay in Adult Arnold-Chiari Type II Malformation With Tracheoesophageal Fistula and Syringomyelia: A Case Report.pubmed.ncbi.nlm.nih.gov
36. Congenital bronchobiliary fistula in a newborn: a case report.pubmed.ncbi.nlm.nih.gov
37. An esophageal-pleural fistula following transesophageal echocardiography-guided left atrial appendage closure: a case report.pubmed.ncbi.nlm.nih.gov
38. Diagnosis of esophageal pleural fistula via metagenomic next-generation sequencing of pleural effusion: a case report.pubmed.ncbi.nlm.nih.gov
39. Pancreatopleural Fistula Presenting as Recurrent Right-Sided Pleural Effusion: A Case Report.pubmed.ncbi.nlm.nih.gov
40. A Rare Case of Boerhaave Syndrome With Chylothorax Managed by an Endoscopic Over-the-scope Clip.pubmed.ncbi.nlm.nih.gov
41. Mediastinitis secondary to esophageal rupture; A case of Boerhaave syndrome.pubmed.ncbi.nlm.nih.gov
42. Boerhaave Syndrome Caused by Pancreatitis-Induced Gastric Outlet Obstruction: A Case Report.pubmed.ncbi.nlm.nih.gov
43. Cholecystogastric fistula presenting with transient gallstone ileus and incidental Fitz-Hugh-Curtis syndrome: A rare radiological and intraoperative association.pubmed.ncbi.nlm.nih.gov
44. Primary Cardiac Angiosarcoma in a Young Male: Rare Presentation With Right Atrial Endocardial Dissection and Right Coronary Artery Tumor Fistula.pubmed.ncbi.nlm.nih.gov
45. Diagnostic challenges in boerhaave syndrome with bilateral pleural contamination: complementary roles of computed tomography, endoscopy, and video-assisted thoracoscopic surgery.pubmed.ncbi.nlm.nih.gov
46. Lung Parenchymal and Airway Injuries: Differential Diagnosis and Severity Grading.pubmed.ncbi.nlm.nih.gov
47. Case Report: Right phrenic nerve palsy following esophageal atresia repair: a report of two cases and literature review of management strategies.pubmed.ncbi.nlm.nih.gov
48. Neonatal evaluation by extended (12 area) vs. traditional (6 area) lung ultrasound scoring (NEXT-LUS): a prospective observational study.pubmed.ncbi.nlm.nih.gov
49. Mediastinal drain-induced bronchoperitoneal fistula following esophageal perforation: a case report.pubmed.ncbi.nlm.nih.gov
50. Evaluation of surgical outcomes in esophageal injuries: a 20-year retrospective analysis.pubmed.ncbi.nlm.nih.gov
51. Type IV laryngo-tracheo-esophageal cleft with CPAM in a preterm twin- a case report.pubmed.ncbi.nlm.nih.gov
52. An atypical variant of congenital bronchoesophageal fistula associated with esophageal atresia and right main bronchial atresia and right lung hypoplasia in a preterm neonate: a case report.pubmed.ncbi.nlm.nih.gov
53. Comprehensive Insights into Tracheoesophageal Fistula Pathophysiology, Diagnosis, Treatment, and Future Directions.pubmed.ncbi.nlm.nih.gov
54. Pediatric Congenital Tracheobronchial Variants and Their Clinical Significance for Endotracheal Intubation and Airway Management: A Scoping Review of Fetal, Neonatal, and Pediatric Cases.pubmed.ncbi.nlm.nih.gov
55. Surgical management strategies and postoperative outcomes of choledochal cysts in children: the role of preoperative radiological assessment in a retrospective observational study.pubmed.ncbi.nlm.nih.gov
56. Cardiovascular Computed Tomography Angiographic Assessment of Simple Cardiac Shunts in Adults.pubmed.ncbi.nlm.nih.gov
57. Severity-guided management of esophageal perforation: a retrospective cohort study supporting a pragmatic treatment algorithm.pubmed.ncbi.nlm.nih.gov
58. The impact of modified esophageal stenting on oral intake in delayed spontaneous esophageal perforation.pubmed.ncbi.nlm.nih.gov
59. Boerhaave Syndrome-Narrative Review.pubmed.ncbi.nlm.nih.gov
60. Efficacy of mesenchymal stem cells in treating tracheoesophageal fistula via the TLR4/NF-κb pathway in beagle macrophages.pubmed.ncbi.nlm.nih.gov
61. Metagenomic next-generation sequencing-guided management of descending mediastinitis and empyema caused by Segatella baroniae: a case report.pubmed.ncbi.nlm.nih.gov
62. Outcomes of infants undergoing surgery for oesophageal atresia and trachea-oesophageal fistula at a tertiary referral hospital in Tanzania.pubmed.ncbi.nlm.nih.gov
63. Esophageal Atresia in Asia: Regional Disparities in Incidence, Congenital Anomalies, Mortality, and Morbidity - A Systematic Narrative Review.pubmed.ncbi.nlm.nih.gov
64. Spatial associations between esophageal lesions and surrounding tissues in esophageal fistula: a CAM-guided radiomics study.pubmed.ncbi.nlm.nih.gov
65. Successful Staged Surgery for Esophagopulmonary Fistula with Lung Abscess During Neoadjuvant Chemoradiotherapy.pubmed.ncbi.nlm.nih.gov
66. A special type of internal hernia - Roux-en-Y limb space internal hernia after gastrectomy: 6 case reports.pubmed.ncbi.nlm.nih.gov
67. War-related penetrating cervicothoracic trauma managed in a resource-limited hospital in Syria: a case series.pubmed.ncbi.nlm.nih.gov
68. Esophageal Perforation Following Small-Bore Nasogastric Tube Placement: A Case Report.pubmed.ncbi.nlm.nih.gov
69. Early and Late Complications After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: A Narrative Review.pubmed.ncbi.nlm.nih.gov
70. Anatomical Variations in Critical Structures in Esophageal Surgery: Implications for Personalized Surgery.pubmed.ncbi.nlm.nih.gov
71. Airway Ultrasound: Applications in Pediatric Anesthesiology and Critical Care.pubmed.ncbi.nlm.nih.gov
72. Safety and feasibility of a novel bronchoplasty-based approach for the resection of middle mediastinal tumors located beneath the carina: a real-world study.pubmed.ncbi.nlm.nih.gov
73. Gallstone ileus due to a visible cholecystoduodenal fistula with pneumobilia CT diagnosis and surgical management: A case report.pubmed.ncbi.nlm.nih.gov
74. Hybrid eclipse: a case of isolated renal tuberculosis with an unusual infectious-inflammatory-neoplastic triad.pubmed.ncbi.nlm.nih.gov
75. Ectopic ureter opening into the vagina in an adult with duplex kidney: a case report and literature review.pubmed.ncbi.nlm.nih.gov
76. Temporary Esophageal Exclusion With Absorbable Ligatures: A Salvage Strategy for Pediatric Button Battery-Related Perforation.pubmed.ncbi.nlm.nih.gov
77. Idiopathic esophageal intramural hematoma associated with hemothorax leading to esophageal perforation.pubmed.ncbi.nlm.nih.gov
78. Inflammation-guided timing of thoracoscopic repair for recurrent tracheoesophageal fistula: predictive value of preoperative chest CT and a transfer learning model.pubmed.ncbi.nlm.nih.gov
79. Fatal multi-organ failure following delayed diagnosis of ruptured pulmonary hydatid cyst in an 11-year-Old boy: The airway management dilemma ('intubate or not intubate').pubmed.ncbi.nlm.nih.gov
80. Benign Emptying After Right Lower Lobectomy Mimicking a Bronchopleural Fistula.pubmed.ncbi.nlm.nih.gov
81. Beyond resection: imaging findings of expected and complicated postoperative changes in lung cancer.pubmed.ncbi.nlm.nih.gov
82. Postoperative Pulmonary Complications: Clinical and Imaging Insightspubmed.ncbi.nlm.nih.gov
83. Clinical and swallowing characteristics of tracheostomized patients with post-intubation acquired tracheal or laryngotracheal stenosis.pubmed.ncbi.nlm.nih.gov
84. The diseases of airway-tracheal diverticulum: a review of the literature.pubmed.ncbi.nlm.nih.gov
85. Definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma: a consensus statement by the International Study Group on Pancreatic Surgery (ISGPS).pubmed.ncbi.nlm.nih.gov
86. Pathology Competencies in Medical Education and Educational Cases: Update 2023.pubmed.ncbi.nlm.nih.gov
87. Preoperative Cardiopulmonary Exercise Test Associated with Postoperative Outcomes in Patients Undergoing Cancer Surgery: A Systematic Review and Meta-Analyses.pubmed.ncbi.nlm.nih.gov
88. Endotherapy of leaks and fistula.pubmed.ncbi.nlm.nih.gov
89. Bronchoscopy-Guided Intratracheal Suture Repair of Recurrent Tracheoesophageal Fistula in an Adolescent.pubmed.ncbi.nlm.nih.gov
90. Demystifying the persistent pneumothorax: role of imaging.pubmed.ncbi.nlm.nih.gov
91. Acquired Tracheoesophageal Fistulas: A Case Report and Review of Diagnostic and Management Challenges.pubmed.ncbi.nlm.nih.gov
92. Direct and indirect CT imaging features of esophago-airway fistula in adults.pubmed.ncbi.nlm.nih.gov
93. Multimodal Treatment of a Complicated Esophagopleural Fistula After Boerhaave's Syndrome: Successful Resolution With Endoscopic Vacuum Therapy.pubmed.ncbi.nlm.nih.gov
94. Surgical strategy for closure of postoperative bronchopleural fistula: a narrative review.pubmed.ncbi.nlm.nih.gov
95. Establishing an esophago-pleural fistula disease model in rabbits with a magnetic compression technique.pubmed.ncbi.nlm.nih.gov
96. Individualized Stent for Tracheal Fistula Complicating Tracheostomy Following Esophagectomy.pubmed.ncbi.nlm.nih.gov
97. Esophageal Exclusion and Retrosternal Bypass in Management of Post-Pneumonectomy Esophagopleural Fistula: A Case Report.pubmed.ncbi.nlm.nih.gov
98. Achalasia-induced catastrophe in pregnancy: Empyema, esophageopleural fistula, septic shock, fetomaternal survival, multidisciplinary management, and literature review. A case report.pubmed.ncbi.nlm.nih.gov
99. Tannerella forsythia, Fusobacterium nucleatum, and Suspected Actinomyces Causing Massive Empyema: A Case Report.pubmed.ncbi.nlm.nih.gov
100. Endoluminal vacuum therapy in the management of an esophago-pleural fistula as a complication of Boerhaave syndrome in a patient with eosinophilic esophagitis.pubmed.ncbi.nlm.nih.gov
101. Perioperative care of a large left bronchoesophageal fistula complicated by achalasia cardia for video-assisted transthoracic BEF repair: A case report.pubmed.ncbi.nlm.nih.gov
102. Esophagobronchial Fistula Associated With Thoracoabdominal Aortic Aneurysmal Disease and Type IA Endoleak: When Dysphagia Precedes Respiratory Failure.pubmed.ncbi.nlm.nih.gov
103. Right-sided colopleural fistula secondary to diverticular disease: a case report.pubmed.ncbi.nlm.nih.gov
104. Magnetic resonance imaging features of neonatal congenital pyriform sinus fistula: a retrospective study of 12 patients.pubmed.ncbi.nlm.nih.gov
105. Esophageal intramural pseudodiverticulosis.pubmed.ncbi.nlm.nih.gov
106. Esophageal and Oropharyngeal Dysphagia: Clinical Recommendations From the United European Gastroenterology and European Society for Neurogastroenterology and Motility.pubmed.ncbi.nlm.nih.gov
107. Non-Infectious Granulomatous Lung Disease: Imaging Findings with Pathologic Correlation.pubmed.ncbi.nlm.nih.gov
108. Spontaneous esophageal-pleural fistula.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.