Successful closure of thoracic fenestration in a patient with traumatic gastric tube-pleural fistula

• Published in: The Journal of the Japanese Association for Chest Surgery Vol. 34; no. 7; pp. 781 - 786
• Main Authors: Kobayashi, Kenichi, Osaki, Toshihiro, Fukuichi, Yukiko, Nishizawa, Natsumasa, Yasuda, Manabu
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Association for Chest Surgery 15.11.2020
• Subjects: gastric tube-pleural fistula; hyperbaric oxygen therapy; thoracic fenestration; trauma
• ISSN: 0919-0945; 1881-4158
• DOI: 10.2995/jacsurg.34.781

We report a multidisciplinary treatment for pyothorax caused by a traumatic reconstructed gastric-thoracic fistula after esophageal cancer surgery. To our knowledge, there has been no report of a thoracic fistula due to traumatic reconstructed gastric tube injury. A 72-year-old man with a history of falling 3 weeks earlier was diagnosed with acute respiratory failure due to multiple bilateral rib fractures and traumatic hemopneumothorax. After bilateral thoracic drainage and ventilator management, the respiratory status improved, but he showed right empyema. CT suggested a reconstructed gastric tube injury and gastrointestinal endoscopy confirmed the fistula. The fistula was directly closed with sutures, but it recurred. After fenestration and enterostomy, adequate nutritional management and hyperbaric oxygen therapy were performed, and the fistula was cured.