esophageal fistula


Summary: Abnormal passage communicating with the ESOPHAGUS. The most common type is TRACHEOESOPHAGEAL FISTULA between the esophagus and the TRACHEA.

Top Publications

  1. Porcu P, Chavanon O, Sessa C, Thony F, Aubert A, Blin D. Esophageal fistula after endovascular treatment in a type B aortic dissection of the descending thoracic aorta. J Vasc Surg. 2005;41:708-11 pubmed
    ..Despite this aggressive surgical approach and an initial favorable postoperative course, the patient suddenly died 3 weeks later, likely from a rupture of the aortic stump. ..
  2. Cagli S, Isik H, Zileli M. Cervical screw missing secondary to delayed esophageal fistula: case report. Turk Neurosurg. 2009;19:437-40 pubmed
    ..Spontaneous perforation of the esophagus and screw loss via the gastrointestinal tract make this case interesting....
  3. Eggebrecht H, Mehta R, Dechene A, Tsagakis K, Kühl H, Huptas S, et al. Aortoesophageal fistula after thoracic aortic stent-graft placement: a rare but catastrophic complication of a novel emerging technique. JACC Cardiovasc Interv. 2009;2:570-6 pubmed publisher
  4. Isasti G, Gómez Doblas J, Olalla E. Aortoesophageal fistula: an uncommon complication after stent-graft repair of an aortic thoracic aneurysm. Interact Cardiovasc Thorac Surg. 2009;9:683-4 pubmed publisher
    ..AEF is a catastrophic complication of endovascular stent-graft placement. Treatment options are very limited, as these patients are usually not candidates for open surgery. Conservative treatment is often associated with fatal results. ..
  5. Good E, Oral H, Lemola K, Han J, Tamirisa K, Igic P, et al. Movement of the esophagus during left atrial catheter ablation for atrial fibrillation. J Am Coll Cardiol. 2005;46:2107-10 pubmed
    ..Therefore, real-time imaging of the esophagus may be helpful in reducing the risk of esophageal injury during radiofrequency ablation along the posterior left atrium. ..
  6. Cummings J, Schweikert R, Saliba W, Burkhardt J, Kilikaslan F, Saad E, et al. Brief communication: atrial-esophageal fistulas after radiofrequency ablation. Ann Intern Med. 2006;144:572-4 pubmed
    ..Formation of atrial-esophageal fistulas is a rare but potentially devastating complication of atrial fibrillation ablation. This disorder may have an indolent presentation and may mimic other disease states, such as stroke or sepsis. ..
  7. Gupta K, Manchanda M, Vermas M. Tuberculous oesophagopleural fistula. J Indian Med Assoc. 2011;109:504-5 pubmed
    ..The fistulous connection between these structures appeared to be due to tuberculous mediastinal lymphadenopathy as evident on CT thorax...
  8. Kim K, Shin J, Song H, Ko G, Kim J, Yoon H, et al. Palliative treatment of malignant esophagopulmonary fistulas with covered expandable metallic stents. AJR Am J Roentgenol. 2009;193:W278-82 pubmed publisher
    ..The objective of our study was to evaluate the safety and clinical effectiveness of covered expandable metallic stents for palliative treatment of malignant esophagopulmonary fistulas...
  9. Nam D, Shin J, Song H, Jung G, Han Y. Malignant esophageal-tracheobronchial strictures: parallel placement of covered retrievable expandable nitinol stents. Acta Radiol. 2006;47:3-9 pubmed
    ..50 days (range 7-375 days). Parallel placement of covered retrievable expandable metallic stents is safe and effective for the palliative treatment of malignant esophageal and tracheobronchial strictures. ..

More Information


  1. Freeman R, Ascioti A, Wozniak T. Postoperative esophageal leak management with the Polyflex esophageal stent. J Thorac Cardiovasc Surg. 2007;133:333-8 pubmed
    ..These stents also offer an appealing alternative to traditional esophageal diversion and subsequent reconstruction in patients with a persistent esophageal leak. ..
  2. Balazs A, Kupcsulik P, Galambos Z. Esophagorespiratory fistulas of tumorous origin. Non-operative management of 264 cases in a 20-year period. Eur J Cardiothorac Surg. 2008;34:1103-7 pubmed publisher
    ..The objective was to reveal the incidence, causes and characteristics of fistula formation and to examine the possibilities and efficiency of the treatment...
  3. Hu Y, Zhao Y, Chen L, Zhu Z, Liu L, Wang Y, et al. Comparative study of different treatments for malignant tracheoesophageal/bronchoesophageal fistulae. Dis Esophagus. 2009;22:526-31 pubmed publisher
    ..With patients' QOL considered, the self-expandable coated stenting should be the first choice of therapy for malignant tracheoesophageal/bronchoesophageal fistula, whereas gastrostomy should be kept from use. ..
  4. Inoue T, Nishino T, Peng Y, Saga T. Successful one-stage operation of aortoesophageal fistula from thoracic aneurysm using a rifampicin-soaked synthetic graft. Interact Cardiovasc Thorac Surg. 2008;7:322-4 pubmed
    ..This is the original report of the surgical repair of aortoesophageal fistula using a rifampicin-soaked graft. ..
  5. Kotzampassakis N, Christodoulou M, Krueger T, Demartines N, Vuillemier H, Cheng C, et al. Esophageal leaks repaired by a muscle onlay approach in the presence of mediastinal sepsis. Ann Thorac Surg. 2009;88:966-72 pubmed publisher
    ..The same holds true for fulminant intrathoracic anastomotic leaks after esophagectomy or other surgical interventions at the gastroesophageal junction. ..
  6. Millar A, Rostom A, Rasuli P, Saloojee N. Upper gastrointestinal bleeding secondary to an aberrant right subclavian artery-esophageal fistula: a case report and review of the literature. Can J Gastroenterol. 2007;21:389-92 pubmed
    ..A case of a 57-year-old man presenting with melena and hypotension secondary to an ARSA-esophageal fistula is reported...
  7. Martinek M, Bencsik G, Aichinger J, Hassanein S, Schoefl R, Kuchinka P, et al. Esophageal damage during radiofrequency ablation of atrial fibrillation: impact of energy settings, lesion sets, and esophageal visualization. J Cardiovasc Electrophysiol. 2009;20:726-33 pubmed publisher
    ..Lower energy settings may increase safety without losing efficacy. Additional linear radiofrequency lesions increase the risk of ESUL development. ..
  8. Prokakis C, Koletsis E, Apostolakis E, Dedeilias P, Dougenis D. Aortoesophageal fistulas due to thoracic aorta aneurysm: surgical versus endovascular repair. Is there a role for combined aortic management?. Med Sci Monit. 2008;14:RA48-54 pubmed
  9. Jain K, Braze A, Shapiro M, Perez Tamayo R. Aberrant right subclavian artery-esophageal fistula and severe gastrointestinal bleeding after surgical correction of scimitar syndrome. Tex Heart Inst J. 2012;39:571-4 pubmed
    Scimitar syndrome and gastrointestinal bleeding from an aberrant right subclavian artery-esophageal fistula are each extremely rare...
  10. Eggebrecht H, Baumgart D, Radecke K, von Birgelen C, Treichel U, Herold U, et al. Aortoesophageal fistula secondary to stent-graft repair of the thoracic aorta. J Endovasc Ther. 2004;11:161-7 pubmed
    ..Treatment options are very limited, as these patients are usually not candidates for open surgery. Outcome under conservative management is, however, almost invariably fatal. ..
  11. Pappone C, Oral H, Santinelli V, Vicedomini G, Lang C, Manguso F, et al. Atrio-esophageal fistula as a complication of percutaneous transcatheter ablation of atrial fibrillation. Circulation. 2004;109:2724-6 pubmed
    ..An atrio-esophageal fistula was identified in both patients...
  12. Hance K, Hsu J, Eskew T, Hermreck A. Secondary aortoesophageal fistula after endoluminal exclusion because of thoracic aortic transection. J Vasc Surg. 2003;37:886-8 pubmed
    ..The endoluminal graft was explanted, with primary repair of the thoracic aortic defect and simultaneous primary repair of the esophageal injury. The patient is well 15 months after open repair of the AEF. ..
  13. Yasuda F, Shimono T, Tonouchi H, Shimpo H, Yada I. Successful repair of an aortoesophageal fistula with aneurysm from esophageal diverticulum. Ann Thorac Surg. 2002;73:637-9 pubmed
    ..In this case, esophageal diverticulum was diagnosed before the development of an aortoesophageal fistula associated with an aneurysm...
  14. Ctercteko G, Mok C. Aorta-esophageal fistula induced by a foreign body: the first recorded survival. J Thorac Cardiovasc Surg. 1980;80:233-5 pubmed
    Two cases of aorta-esophageal fistula (AEF) resulting from a foreign body in the esophagus are presented. One we believe to be the first recorded survival...
  15. Unosawa S, Akiyama K, Nakata K, Masuda H, Wakabayashi K, Shiratori R, et al. Successful surgical treatment for an aortoesophageal fistula due to a descending aortic aneurysm. Ann Thorac Cardiovasc Surg. 2003;9:257-60 pubmed
    ..This study reports the course of a patient with an aortoesophageal fistula due to a thoracic aortic aneurysm whose life was successfully saved by emergency surgery, together with literature. ..
  16. Kieffer E, Chiche L, Gomes D. Aortoesophageal fistula: value of in situ aortic allograft replacement. Ann Surg. 2003;238:283-90 pubmed
    ..aorta to abdominal aorta bypass grafting, removal of the prosthesis, esophageal exclusion, and directed esophageal fistula. She died of infection. The other 4 patients were treated by in situ aortic allograft replacement...
  17. Kato N, Tadanori H, Tanaka K, Yasuda F, Iwata M, Kawarada Y, et al. Aortoesophageal fistula-relief of massive hematemesis with an endovascular stent-graft. Eur J Radiol. 2000;34:63-6 pubmed
    ..5 months later, which was caused by a tracheoesophageal fistula. Stent-graft repair is a safe and effective method to treat aortoesophageal fistula and may be an alternative to surgical resection...
  18. Flores J, Shiiya N, Kunihara T, Yoshimoto K, Yasuda K. Aortoesophageal fistula: alternatives of treatment case report and literature review. Ann Thorac Cardiovasc Surg. 2004;10:241-6 pubmed
    ..We also include a discussion on criteria for selecting the most appropriate alternative of treatment: open or endovascular repair, based on a review of the literature currently available in MEDLINE. ..
  19. Scanavacca M, d Avila A, Parga J, Sosa E. Left atrial-esophageal fistula following radiofrequency catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15:960-2 pubmed
    This report describes a fatal case of left atrial-esophageal fistula occurring in a 72-year-old man after a radiofrequency catheter ablation of paroxysmal atrial fibrillation...
  20. Shin J, Song H, Ko G, Lim J, Yoon H, Sung K. Esophagorespiratory fistula: long-term results of palliative treatment with covered expandable metallic stents in 61 patients. Radiology. 2004;232:252-9 pubmed
    ..To evaluate long-term clinical results of palliative treatment of esophagorespiratory fistulas (ERFs) with covered expandable metallic stents...
  21. D Costa H, Bailey F, McGavigan B, George G, Todd B. Perforation of the oesophagus and aorta after eating fish: an unusual cause of chest pain. Emerg Med J. 2003;20:385-6 pubmed
    ..In the case described here, the fistula was demonstrated on contrast computed tomography before surgery, thus informing surgical management. The patient is the eighth reported survivor. ..
  22. Wang M, Sze D, Wang Z, Wang Z, Gao Y, Dake M. Delayed complications after esophageal stent placement for treatment of malignant esophageal obstructions and esophagorespiratory fistulas. J Vasc Interv Radiol. 2001;12:465-74 pubmed
    ..05). Thirteen patients (15.9%) died from complications directly related to stent placement. Esophageal stent placement for malignant obstruction or fistula is associated with a substantial incidence of delayed complications. ..
  23. Snyder D, Crawford E. Successful treatment of primary aorta-esophageal fistula resulting from aortic aneurysm. J Thorac Cardiovasc Surg. 1983;85:457-63 pubmed
    ..that rupture occurs into the esophagus in 10% of the cases and constitutes the most common cause of aorta-esophageal fistula. A reasonable literature review has not revealed a previously successful treatment for this condition...
  24. Assink J, Vierhout B, Snellen J, Benner P, Paul M, Cuesta M, et al. Emergency endovascular repair of an aortoesophageal fistula caused by a foreign body. J Endovasc Ther. 2005;12:129-33 pubmed
    ..Blood parameters of infection were normal; the patient remains well 18 months after stent-graft implantation. This case illustrates stent-graft treatment of a life-threatening hemorrhage from an aortoesophageal fistula. ..
  25. Sica G, Djapardy V, Westaby S, Maynard N. Diagnosis and management of aortoesophageal fistula caused by a foreign body. Ann Thorac Surg. 2004;77:2217-8 pubmed
    ..A case of aortoesophageal fistula caused by a swallowed fish bone leading to respiratory arrest is reported. The clinical presentation was unusual. The successful treatment required the use of hypothermic circulatory arrest. ..
  26. Reardon M, Brewer R, Lemaire S, Baldwin J, Safi H. Surgical management of primary aortoesophageal fistula secondary to thoracic aneurysm. Ann Thorac Surg. 2000;69:967-70 pubmed
    ..We report a successful repair of primary aortoesophageal fistula, secondary to descending thoracic aortic aneurysm, and review the evolution of management since the three previously reported successful repairs at our institution. ..
  27. Feng X, Xiong X. Extralobar pulmonary sequestration in the right lower thoracic region associated with esophageal fistula. Thorac Cardiovasc Surg. 2013;61:507-9 pubmed publisher
    ..We report the case of a 10-year-old girl with ELS in the right thoracic cavity, associated with esophageal fistula. Chest computed tomography scans revealed a parenchymal mass between the right lower lobe and the diaphragm...
  28. Eitel C, Rolf S, Zachäus M, John S, Sommer P, Bollmann A, et al. Successful nonsurgical treatment of esophagopericardial fistulas after atrial fibrillation catheter ablation: a case series. Circ Arrhythm Electrophysiol. 2013;6:675-81 pubmed publisher
    ..However, constant interdisciplinary communication and attention is needed to recognize and manage potential evolving complications promptly. ..
  29. Bona D, Laface L, Bonavina L, Abate E, Schaffer M, Ugenti I, et al. Covered nitinol stents for the treatment of esophageal strictures and leaks. World J Gastroenterol. 2010;16:2260-4 pubmed
    ..34). Removal of the Choostent was possible up to 8 wk without difficulty. Ultraflex and Choostent proved to be equally reliable for palliation of dysphagia and leaks. Removal of the Choostent was easy and safe under mild sedation. ..
  30. Hamamoto Y, Nagasao T, Niyazi A, Tamai M, Tanaka Y. Utilization of a sero-muscular patch for safe wound closure after free jejunum transfer for a skin-esophageal fistula. Surg Today. 2017;47:891-894 pubmed publisher
    ..This paper introduces our original technique of free jejunum transfer, in which a sero-muscular patch is used to cover the jejunum. Our results demonstrate its effectiveness for touch-up surgery after esophageal leakage. ..
  31. Brams A, Bulois P, Maunoury V, Triboulet J, Mariette C. [Treatment of thoracic anastomotic leaks after oesophagectomy with self-expanding and extractible covered stent]. Gastroenterol Clin Biol. 2008;32:41-5 pubmed publisher
    ..Intrathoracic, covered oesophageal stents appears to reduce leak-morbidity after oesophagectomy and may be considered as a cost-effective treatment alternative. ..
  32. Baltasar A, Bou R, Bengochea M, Serra C, Cipagauta L. Use of a Roux limb to correct esophagogastric junction fistulas after sleeve gastrectomy. Obes Surg. 2007;17:1408-10 pubmed
    ..The Roux limb resolved a dangerous EGJ leak after a LSG. ..
  33. Freeman R, Ascioti A, Giannini T, Mahidhara R. Analysis of unsuccessful esophageal stent placements for esophageal perforation, fistula, or anastomotic leak. Ann Thorac Surg. 2012;94:959-64; discussion 964-5 pubmed publisher
    ..These potential contraindications should be considered when developing a treatment plan for individual patients and may prompt traditional operative repair as initial therapy. ..
  34. Ishikawa N, Maruta K, Oi M, Iizuka H, Kawaura H, Omoto T. Thoracic endovascular repair for aorto-esophageal fistula in patients with esophageal carcinoma: report of 3 cases. Vasc Endovascular Surg. 2013;47:65-9 pubmed publisher
    Aorto-esophageal fistula (AEF) is a rare complication of esophageal carcinoma...
  35. Ozer M, Demirbas S, Harlak A, Ersoz N, Eryilmaz M, Cetiner S. A rare complication after thyroidectomy: perforation of the oesophagus: a case report. Acta Chir Belg. 2009;109:527-30 pubmed
    ..This well-documented case is discussed in conjunction with the information presented in the literature. ..
  36. Hihara J, Hamai Y, Emi M, Aoki Y, Taomoto J, Miyata Y, et al. Esophageal bypass operation prior to definitive chemoradiotherapy in advanced esophageal cancer with tracheobronchial invasion. Ann Thorac Surg. 2014;97:290-5 pubmed publisher
    ..Esophageal bypass surgery prior to definitive chemoradiotherapy could be performed safely, and this strategy contributed to long-term survival in the patients who achieved a good response to chemoradiotherapy but developed an ERF. ..
  37. Zirlik A, Nordt T. Massive air embolism after Maze. Heart. 2005;91:736 pubmed
  38. Henriques A, Godinho C, Saad R, Waisberg D, Zanon A, Speranzini M, et al. Esophagogastric anastomosis with invagination into stomach: New technique to reduce fistula formation. World J Gastroenterol. 2010;16:5722-6 pubmed
    ..Cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach tube presented a low rate of esophagogastric fistula with mild clinical repercussions. ..
  39. Finsterer J, Stollberger C, Pulgram T. Neurological manifestations of atrio-esophageal fistulas from left atrial ablation. Eur J Neurol. 2011;18:1212-9 pubmed publisher
    ..An increasingly recognized complication of LAAB is an atrio-esophageal fistula (AEF)...
  40. Rieder F, Hamer O, Gelbmann C, Scholmerich J, Gross V, Feuerbach S, et al. Crohn's disease of the esophagus: treatment of an esophagobronchial fistula with the novel liquid embolic polymer "onyx". Z Gastroenterol. 2006;44:599-602 pubmed fourteen cases have been described in the literature -- the course of the illness may be complicated by esophageal fistula formation...
  41. Raghavendran K, Cherr G, Ford P, Burkhard P, Bell Thomson J. Successful management of concomitant aortoesophageal and aortotracheal fistulae secondary to a thoracic aortic aneurysm: case report and review of literature. J Vasc Surg. 2005;42:1218-20 pubmed
    ..The patient had a successful outcome after resection of the aneurysm with tracheal repair and esophageal resection. A review of literature on this subject is also included in this manuscript. ..
  42. Kuo K, Hsu H, Pan Y, Huang C. Carotid blowout and cerebral gas embolism related to bidirectional carotid-esophageal fistula: a serious complication of esophageal cancer under radiotherapy. Am J Emerg Med. 2016;34:683.e5-6 pubmed publisher
    Carotid-esophageal fistula (CEF) could be a serious complication of esophageal cancer in a patient receiving radiotherapy...
  43. Abraham M, Sudarsanan B, Viswanath N, Puzhankara R, Palliwal A, Naaz A, et al. A safer way of suturing in Foker's technique. J Pediatr Surg. 2013;48:1819-21 pubmed publisher
    ..In the first case it took twelve days, in the second case six days, and in third case eight days for the ends to come together. This modification of traction sutures is simple and reduces the risk of suture disruption. ..
  44. Atre A, Sangle P, Jadhav A. Preoperative demonstration of broncho-esophageal fistula by multidetector computed tomography. Indian J Gastroenterol. 2007;26:134 pubmed
  45. Shatnawi N, Bani Hani K. Ingested chicken bone leading to aorto-esophageal fistula. Saudi Med J. 2005;26:1442-4 pubmed
    ..The bleeding proved to be due to aorto-esophageal fistula caused by accidental ingestion of a chicken wing bone 10 days earlier...
  46. Agustsson T, Nilsson M, Henriksson G, Arnelo U, Juto J, Lundell L. Treatment of postoperative esophagorespiratory fistulas with dual self-expanding metal stents. World J Surg. 2009;33:1224-8 pubmed publisher
    ..This strategy has to be prolonged and aggressive with a commitment to repeatedly change stents and modify sizes and designs. Thereby a majority of these patients can be managed conservatively with prospects of a successful outcome. ..
  47. Stringari C, Sbraga P, Zaraca F. Endovascular treatment of a left subclavian pseudoaneurysm induced by ingestion of a foreign body. Ann Vasc Surg. 2013;27:672.e7-11 pubmed publisher
    Subclavian artery-esophageal fistula is a life-threatening entity. It usually occurs in cases of an aberrant right subclavian artery...
  48. Green D, Moskowitz W, Shepherd R. Closure of a broncho-to-neoesophageal fistula using an Amplatzer Septal Occluder device. Ann Thorac Surg. 2010;89:2010-2 pubmed publisher
    ..The device was deployed under direct visualization through rigid bronchoscopy. ..
  49. Danon A, Shurrab M, Nair K, Latcu D, Arruda M, Chen X, et al. Atrial fibrillation ablation using remote magnetic navigation and the risk of atrial-esophageal fistula: international multicenter experience. J Interv Card Electrophysiol. 2015;43:169-74 pubmed publisher
    ..Atrial-esophageal fistula (AEF) is one of most disastrous complications of AF ablation...
  50. Rinkel R, van Poll D, Sibarani Ponsen R, Sleeboom C, Bakx R. Bronchoscopy and Fogarty Balloon Insertion of Distal Tracheo-Oesophageal Fistula for Oesophageal Atresia Repair With Video Illustration. Ann Otol Rhinol Laryngol. 2017;126:6-8 pubmed
    During repair of esophageal atresia with distal tracheo-esophageal fistula, air leakage through the fistula during mechanical ventilation can cause respiratory demise...
  51. McWhorter V, Dunn J, Teitell M. Aortoesophageal fistula as a complication of Montgomery salivary bypass tube. J Pediatr Surg. 2005;40:742-4 pubmed
    ..The authors describe a 2-year-old girl with a right-sided aortic arch who developed a sudden, fatal aortoesophageal fistula after prolonged placement of Montgomery salivary bypass tubes in the distal esophagus. ..
  52. Kubota S, Shiiya N, Shingu Y, Wakasa S, Ooka T, Tachibana T, et al. Surgical strategy for aortoesophageal fistula in the endovascular era. Gen Thorac Cardiovasc Surg. 2013;61:560-4 pubmed publisher
  53. Teijo Núñez C, Mostaza Fernández J, Pérez Andrada S, Pérez Simón M. [Tuberculous esophagomediastinal fistula in a HIV-infected patient]. Enferm Infecc Microbiol Clin. 2007;25:66-7 pubmed