jksronline.org
eISSN 2951-0805
    J Korean Soc Radiol. 2014 Mar;70(3):209-212. Korean.
    Published online Mar 12, 2014.
    https://doi.org/10.3348/jksr.2014.70.3.209
    Copyright © 2014 The Korean Society of Radiology
    Case Report

    Esophago-Pleural Fistula with Multiple Esophageal Ulcers in Human Immunodeficiency Virus Infected Patient: A Case Report

    Soo Hee Kwon, MD,1 Young Kyung Lee, MD,1 Jae-Phil Choi, MD,2 and Jin Sung Son, MD3
      • 1Department of Radiology, Seoul Medical Center, Seoul, Korea.
      • 2Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.
      • 3Department of Thoracic and Cardiovascular Surgery, Seoul Medical Center, Seoul, Korea.
    • Corresponding author: Young Kyung Lee, MD. Department of Radiology, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul 131-865, Korea. Tel. 82-2-2276-7000, Fax. 82-2-2276-7093, Email: ykradio@medimail.co.kr
    Received November 07, 2013; Accepted January 21, 2014.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Esophagitis is a common complication in patients with human immunodeficiency virus (HIV) infection. Esophagitis in HIV infected patient is caused by candidiasis, cytomegalovirus, herpes simplex virus, or idiopathic esophagitis with no detectable etiology. Esophagitis in HIV infected patient is occasionally combined with esophageal ulcers. We report chest CT findings and clinical manifestation of esophago-pleural fistula with pneumothorax in a HIV infected patient, who was treated for aspiration pneumonia and esophageal ulcers.

    Keywords
    Esophagitis; Fistula; Human Immunodeficiency Virus

    Figures

    Fig. 1
    A 29-year-old HIV infected man with esophago-pleural fistula.

    A. A non-enhanced low dose chest CT scan shows multiple ill-defined centrilobular nodules and bronchial wall thickening in left lower lobe.

    B, C. A non-enhanced low dose chest CT scan shows upper esophageal wall thickening with luminal irregularity (arrow).

    D. A non-enhanced low dose chest CT scan with lung setting shows pneumomediastinum around upper esophagus (black arrowhead).

    E. An esophagogastroduodenoscophy shows deep esophageal ulcer (arrow) and diffuse desquamation of mucosa.

    F. A chest radiography (anteroposterior view) shows right hydropneumothorax (asterisk).

    G, H. A contrast-enhanced CT scan shows esophago-pleural fistula (arrow) between upper esophagus and right pleural space. Multiple air bubbles are presented in dependent portion of right pleural effusion.

    References

      1. Mönkemüller KE, Wilcox CM. Diagnosis and treatment of esophagitis in AIDS. Compr Ther 2000;26:163–168.
      1. Ehrenpreis ED, Bober DI. Idiopathic ulcerations of the oesophagus in HIV-infected patients: a review. Int J STD AIDS 1996;7:77–81.
      1. Wilcox CM, Schwartz DA, Clark WS. Esophageal ulceration in human immunodeficiency virus infection. Causes, response to therapy, and long-term outcome. Ann Intern Med 1995;123:143–149.
      1. Giménez A, Franquet T, Erasmus JJ, Martínez S, Estrada P. Thoracic complications of esophageal disorders. Radiographics 2002;22 Spec No:S247–S258.
      1. Kumar S, Singh A, Matreja PS, Kler SK. A case report of a spontaneous oesophageal pleural fistula. J Clin Diagn Res 2013;7:522–524.
      1. Jang KM, Lee KS, Lee SJ, Kim EA, Kim TS, Han D, et al. The spectrum of benign esophageal lesions: imaging findings. Korean J Radiol 2002;3:199–210.
      1. Han SY, McElvein RB, Aldrete JS, Tishler JM. Perforation of the esophagus: correlation of site and cause with plain film findings. AJR Am J Roentgenol 1985;145:537–540.
      1. Abbott OA, Mansour KA, Logan WD Jr, Hatcher CR Jr, Symbas PN. Atraumatic so-called "spontaneous" rupture of the esophagus. A review of 47 personal cases with comments on a new method of surgical therapy. J Thorac Cardiovasc Surg 1970;59:67–83.
      1. Wechsler RJ. CT of esophageal-pleural fistulae. AJR Am J Roentgenol 1986;147:907–909.
    MeSH Terms
    Candidiasis
    Cytomegalovirus
    Esophagitis
    Fistula*
    HIV*
    Humans*
    Pneumonia, Aspiration
    Pneumothorax
    Simplexvirus
    Tomography, X-Ray Computed
    Ulcer*
    Metrics
    Share
    Figures
    slide

    1 / 1

    PERMALINK