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Anastomotic leakage is one of the most serious complications following surgery of the esophagus. Post-surgical fistula and anastomotic leakage are major causes of morbidity and mortality. The reported incidence of anastomotic leakage after an esophagectomy is between 2.3 % and 5.9 % [1,2]. It is associated with a high rate of mortality. Conservative treatment with nutritional support and antibiotic therapy is usually adopted at first, but this is sometimes insufficient to obliterate leakage or can take 20-30 days, even if it is successful. Anastomotic leakage is usually improved simply by draining the anastomotic site [3], but sometimes an esophago-respiratory fistula occurs due to penetration by the abscess to the trachea or main bronchus [4-6]. This causes a very serious clinical condition, predisposing the patient to life-threatening pneumonia.

Endoscopic Clipping and Application of Fibrin Glue for an Esophago-Mediastinal Fistula