Acquired esophago-respiratory fistulae in adults

Esophago-respiratory fistulae (ERF) are an uncommon group of abnormal connections between the esophagus and various locations in the respiratory tract. While rare, they confer significant morbidity and mortality, especially given that the majority of ERF in adults are acquired due to malignancy. As a result, management strategies are often complicated and should be undertaken with consultation between oncology, thoracic surgery, gastroenterology, and interventional pulmonary colleagues. In this review article we discuss the epidemiology, clinical presentations, etiologies, and diagnosis of ERF. We also discuss management strategies, complications related to management, and the differences in management between benign and malignant etiologies with a focus on bronchoscopic interventions.