Successful conservative management of gastrotracheal fistula after esophagectomy

Gastro-tracheobronchial fistula following esophagogastrostomy is usually fatal, making conservative treatment inadvisable. A 68-year-old man underwent esophagectomy with gastric conduit reconstruction in the posterior mediastinum and neck anastomosis. Despite anastomotic leakage on postoperative day 8, the patient was stable and was managed conservatively. On day 28, a gastric tube–bronchial fistula was diagnosed by esophagogram, gastrointestinal endoscopy, and bronchoscopy. No inflammatory reaction occurred and the patient remained stable, so conservative management was continued. On day 43, gastrointestinal endoscopy and bronchoscopy showed closure of the hole. The patient progressed well on an oral diet and was discharged. Conservative management is possible in limited cases.