Oesophago-tracheal fistula due to oesophageal cancer and achalasic megaesophagus.

A patient with chest pain and dysphagia presented with a history of achalasic megaesophagus and oesophageal cancer treated with chemoradiotherapy. Computed tomography showed the presence of megaesophagus (Fig. 1), mediastinal involvement and an oesophagotracheal fistula (Fig. 2). A feeding jejunostomy was placed, and the patient was referred for supportive care. Figure 1 : Computed tomography showing megaesophagus. Figure 2: Oesophagotracheal fistula connecting the lumen of the tracheal and the megaesophagus. Neoplastic mediastinal involvement is also visible.