Bronchial carcinoma with an esophageal fistula.
A 60-year-old male patient with known bronchial carcinoma developed increasing dysphagia and recurrent chest infections. A water-soluble swallow examination shows obstruction of the esophagus by a stricture at the level of the aortic arch, with some of the contrast entering the left bronchial tree via a fistula. The mechanism needs to be distinguished from aspiration of contrast into the airway. The patient also has a left phrenic nerve palsy.
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