Abstract

Introduction: Esophagopleural fistula (EPF) is an uncommon condition despite the anatomical proximity of the trachea and esophagus. Spontaneous development of a fistula between the esophagus and pleura is rarely described in the literature.

Case Report: A 45years old male was presented with multiple episode of vomiting, retching following intake of alcohol for 1 day associated with retrosternal chest pain radiating to back with sudden onset of dyspnea & dry cough. CXR s/o right lower zone pneumonia with parapneumonic effusion with B/L subcutaneous emphysema, Repeat CXR showed hydropneumothorax (right). Intercostal chest drainage was inserted.UGI endoscopy showed esophageal ulcer in distal part, HRCT thorax with oral contrast showed a fistulous tract of size 2-3 cm in lower 1/3^rd of esophagus connecting to right pleural cavity, Right hydropneumothorax with ICT in-situ with B/L lung consolidation with left mild PLEF.

Conclusion: Spontaneous development of EPF is an unusual condition entity with nonspecific clinical presentation. CT of chest is a very useful modality for early diagnosis and management of EPF. Management of the EPF depends on site, size, duration, and severity of perforation.