Журнал клинических случаев

Persistent Central Bronchospasm Caused by Esophageal Ulcer Complicated with Esophageal Fistula and Mediastinal Abscess

Abstract

Shao-Hua Lin, Ling Jiang1, Kai Dong, Jun-jie Lian, Qi Zhao and Cun-Kun Chu

Bronchospasm caused by an esophageal fistula or mediastinal abscess is not uncommon. Most of patients occur in small and medium-sized airways. It is rare to take the presentation of persistent central branch tracheal spasm and acute hypoxia as the primary symptoms. This article describes a 63-year-old female patient had a 1-day history of wheezing. Chest CT scan showed evident extensive stenosis of the bilateral central bronchi, and the formation of an abscess around the esophagus. Esophagoscopy revealed esophageal fistula. The patient received a series of anti-infective, antispasmodic, and antiasthmatic therapy methods, and recovered soon. Esophageal fistula caused by esophageal ulcer could occur in some tumor patients, resulting in mediastinal infection for the patients. But esophageal ulcers caused by accidental fishbone stuck in the throat are seldom. Most of the patients firstly may present with some symptoms related to digestive system organs. The study demonstrates the case is the rare presentation of a persistent central bronchial spasm caused by an esophageal ulcer, esophageal fistula, and mediastinal abscess induced by fishbone. We suggest that when patients accidentally are stuck in the throat with fishbone, they should seek medical assistance timely to make a definite diagnosis and treatment as early as possible.