PMC5051476_01
Preoperative X-ray exam - lung opacity at upper right lobe
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F1
The chest X-ray and thoracic CT scans showed pulmonary suppurations located at upper right lobe (Fig. 1, Fig. 2).
Bronchoscopy - bronchial fistula
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F3
Intraoperative aspects: A - upper right lobbectomy;
B - dissection of esophagus and exposure of fistula; 
C - esophageal myotomy
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F4
We performed right upper lobectomy with subcarynary lymphadenectomy and resection of eso-bronchial fistula, suture of esophagus (double layer) with extramucosal esophageal myotomy (Fig. 4).
Postoperative chest X-ray - complete reexpansion of the right lung
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F5
PMC5051476_02
Preoperative esophagography - round esophageal opacity
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F6
Preoperative esophagography with lipiodol - round opacity located at esophagus and left eso-bronchial fistula (Fig. 6; Fig. 7).
Thoracic CT scan: A - left lower lobe pneumonia; B - left eso-bronchial fistula
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F8
Postoperative chest X-ray: right lung ARDS
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F9
ARDS (Fig. 9), with mechanical ventilation for 4 days. After that, favorable outcome appeared; the bronchoscopy performed at 2 months after surgery revealed left main bronchus stenosis and pulmonary atelectasis (Fig. 10).
Postoperative bronchoscopy at 2 months after 
surgery - intermittent stenosis of left main bronchus
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F10
ARDS (Fig. 9), with mechanical ventilation for 4 days. After that, favorable outcome appeared; the bronchoscopy performed at 2 months after surgery revealed left main bronchus stenosis and pulmonary atelectasis (Fig. 10).
Esophageal barium passage - normal
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F11
Chest X ray
after re-thoracotomy
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F12
The postoperative outcomes were favorable, with normal X-ray exams, CT scans and bronchoscopy (Fig. 12, Fig. 13, Fig. 14).
Bronchoscopy after re-thoracotomy - normal aspects
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F14
The postoperative outcomes were favorable, with normal X-ray exams, CT scans and bronchoscopy (Fig. 12, Fig. 13, Fig. 14).
PMC5051476_03
Preoperative CT scan - revealed the eso-tracheal fistula
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F15
Thoracic scans (Fig. 15), bronchoscopic and esophagoscopic exams showed a tracheo-esophageal fistula at cervical trachea, at the level of previous tracheostomy.