| Endoscopic closure of an esophagomediastinal fistula with fibrin glue injection in tuberculous mediastinal lymphadenitis: A case report |
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경북대학교 의과대학 내과학교실1, 계명대학교 의과대학 내과학교실2 |
| Endoscopic closure of an esophagomediastinal fistula with fibrin glue injection in tuberculous mediastinal lymphadenitis: A case report |
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Jin-Kyung Ryu, Hwoon-Yong Jung, Kee-Don Choi, Ho-June Song, Jung-Ho Kim, Gin-Hyug Lee, Jin-Ho Kim |
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| Abstract |
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Esophagomediastinal fistula in tuberculous lymphadenitis is rare complication and generally are resolved with antituberculous
medication. However, surgical management or endoscopically therapeutic approach may be needed as the alternative treatment
in refractory to conservative treatment. We report a case of esophagomediastinal fistula successfully treated with fibrin glue in
patient with tuberculous mediastinal lymphadenitis, of which there was no report in our knowledge. A 66-year-old woman
presented with pleuritic chest pain, cough and foul sputum. Computed tomography of chest showed abnormal air collection with
inhomogeneous densities in the subcarinal region of the mediastinum and cavitary lesion in the right lower lobe. Esophagography
confirmed esophagomediastinal fistula. The fistula was not closed on esophagography 9 weeks after antituberculous therapy.
First endoscopic closure was failed, in which fibrin glue was injected on the margin of the fistula. Second injection of fibrin glue
was performed successfully into the orifice of the fistula. A repeat esophagogram showed no fistulous tract with contrast
leakage. At 8 months after antituberculous therapy, follow-up CT of chest demonstrated no air bubble in mediastinum and
markedly reduction in size of pulmonary cavitary lesion. |
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