대한흉부영상의학회 Korean Society of Thoracic Radiology

대한흉부영상의학회 Weekly Case 메뉴

Close

대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
Advanced Search..

Close

Weekly Chest CasesCases by Disease Category

Case No : 1239 Date 2021-07-21

Add to Favorites

  • Courtesy of Sung Ho Hwang, Yu-Whan Oh / Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
  • Age/Sex 65 / M
  • Chief ComplaintCC: fever and dyspnea. He was treated with esophagectomy and radiotherapy of esophageal cancer. A metallic stent was inserted into the reconstructed esophagus because of the stricture after radiotherapy.
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Tracheoesophageal fistula
Radiologic Findings
Chest radiography (Fig. 1) shows a metallic stent near trachea. Multiple consolidations and ill-defined nodules are noted in bilateral lung fields.
Transverse image (Fig. 2) of contrast chest CT shows multiple consolidations, ground-glass opacities, and ill-defined centrilobular nodules.
Sagittal image (Fig. 3) of contrast-enhanced chest CT shows a small defect (arrow) between trachea and esophagus, just above the metallic stent.
ronchoscopy (Fig. 4) shows a small defect of tracheal posterior wall, which indicates a tracheoesophageal fistula.
Brief Review
Tracheoesophageal fistula (TEF) is defined as a pathological connection between the trachea and the esophagus, leading to a spillover of oral and gastric secretions into the respiratory tract. The most common cancer associated with TEF is esophageal cancer, with >10% of patients developing the condition during its clinical course.
The contrast-enhanced esophagogram demonstrates the defect in patients with TEF. In the patients who are not able to swallow the contrast, computed tomography (CT) scan can be performed to evaluate for signs of fistula, digestive tract anatomy, and mediastinal pathology. Once the thoracic imaging confirms the presence of TEF, the next step is to evaluate the anatomy via endoscopy and bronchoscopy.
For malignant TEFs, the available data suggest drastically worse outcomes. Although there was <0.5% procedure-related mortality, the mean survival of patients with malignant TEF was only about 3 months from the time of TEF diagnosis.
References
1. Davydov M, Stilidi I, Bokhyan V, et al. Surgical treatment of esophageal carcinoma complicated by fistulas. Eur J Cardiothorac Surg 2001; 20: 405
Please refer to
Case 224
Keywords

No. of Applicants : 89

▶ Correct Answer : 84/89,  94.4%
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Korea University Guro Hospital , Korea (South) SEOKYOUNG LEE
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - Showa General Hospital , Japan MASAFUMI KAIUME
  • - Mayo Clinic , United States AKITOSHI INOUE
  • - Chungbuk National University Hospital , Korea (South) YEONGTAE PARK
  • - Other , Korea (South) HYEJIN YANG
  • - , United Kingdom SAMSON KADE
  • - Chonbuk National University Hospital , Korea (South) MINGI SHIN
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - Osaka Red Cross Hospital , Japan YUSUKE UTSUNOMIYA
  • - Seoul Medical Center , Korea (South) WOONYOUNG BAEK
  • - National Center of Neurology and Psychiatry , Japan MOTO NAKAYA
  • - Inje University Haeundae Paik Hospital , Korea (South) HYUNGIN PARK
  • - Seoul National University Bundang Hospital , Korea (South) SOWON JANG
  • - , Italy PAOLO BALDASSARI
  • - , France CHARLES DAMIEN
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - , Japan CHIAKI SATO
  • - Ichinomiya Nishi Hospital , Japan CHIHIRO KIGUCHI
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Korea University Ansan Hospital , Korea (South) BYUK GYUNG CHOI
  • - Other , Korea (South) HEE SEOK CHOI
  • - Other , Korea (South) SEONGSU KANG
  • - , Korea (South) JIN YOUNG LEE
  • - , Korea (South) JUNG-IN JO
  • - , Brazil FERNANDO MORANDINI
  • - Muhimbili National Hospital , Tanzania FREDERICK RICHARD LYIMO
  • - Seoul Medical Center , Korea (South) HYUK GI HONG
  • - Samsung Medical Center , Korea (South) JUHYUN KIM
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - Chonbuk National University Hospital , Korea (South) JUNGHWAN KIM
  • - Osaka University , Japan AKINORI HATA
  • - Shimada General Medical Center , Japan HAYATO NOZAWA
  • - National Center for Global Health and Medicine , Japan MASATOSHI HOTTA
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Seoul National University Bundang Hospital , Korea (South) SUNG HYUN YOON
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Inje University Pusan Paik Hospital , Korea (South) JIYEON HAN
  • - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
  • - Gifu University Hospital , Japan Yo Kaneko
  • - , Japan KANAE TAKAHASHI
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Other , Korea (South) KYOWON GU
  • - , Korea (South) EUNJIN LEE
  • - , Korea (South) SEUNGHYUN LIM
  • - Other , Korea (South) MARI A
  • - Mallinckrodt Institute of Radiology , United States NAGANATHAN MANI
  • - Osaka City General Hospital , Japan SHU MATSUSHITA
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Other , Korea (South) MINSU KIM
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Seoul National University Hospital , Korea (South) SE WOO KIM
  • - CHU Lille , France PAUL LEBERT
  • - , Korea (South) YEJIN JEON
  • - Seoul Veterans Hospital , Korea (South) SEONG WON JANG
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - Columbia asia hospital Hebbal ,Bengaluru , India PRAVIN KUMAR M
  • - Osmania Medical College, Hyderabad , India PURUSHOTHAMA RAO TUMMALA
  • - Chonnam National University Hospital , Korea (South) KIM SANG GYUN
  • - Other , Korea (South) KYU-CHONG LEE
  • - Kyoto University Hospital , Japan SATOSHI IKEDA
  • - Paras hospital, Panchkula , India SHALEEN RANA
  • - Samsung Medical Center , Korea (South) SUHO KIM
  • - Pusan National University Yangsan Hospital , Korea (South) JI HWAN KIM
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - The University of Tokyo Hospital , Japan HIROSHI TAKUMIDA
  • - , Japan KAZUMA TERAUCHI
  • - Yeungnam University Medical Center , Korea (South) YOUNG WOO SIM
  • - Chonnam National University Hospital , Korea (South) SEUNG WAN KANG
  • - Private sector , Greece VASILIOS TZILAS
  • - Govt. Kilpauk Medical College, Chennai , India VIGNESH K
  • - , Japan YUKI HAYASHI
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - , Korea (South) WONJU HONG
  • - Kyoto university , Japan AKIHIKO SAKATA
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - algeria , Algeria ZAKARIA CHERAGA
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Semi-Correct Answer : 2/89,  2.2%
  • - , Japan HIROAKI ARAKAWA
  • - GHICL , France MANUEL TOLEDANO
  • Top
  • Back

Each Case of This Site Supplied by the Members of KSTR.
Copyright of the Images is in the KSTR and Original Supplier.
Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

This website is optimized for IE 10 and above.