Acquired esophago-respiratory fistulae are usually esophago-tracheal or esophago-bronchial. Esophago-pulmonary fistulae have been rarely described.

We report a case of 17-year-old girl with esophago-pulmonary fistula. She experienced a long history of cough and expectoration. CT scans of the chest demonstrated right lower and middle lung lobes multiple cavitary lesions with marked dilatation of the esophagus and a communicating fistula between the esophagus and parenchyma of the right lower lobe of the lung.

Excision of the fistula and right bilobectomy were done via right thoracotomy. The patient was markedly improved after surgery in terms of clinical symptoms and radiologic findings and discharged 18 days after surgery.

Although quite rare, brocho-esophageal fistula can occur as a complication for long standing suppurative lung disease. It should be considered in cases where combined symptoms from suppurative lung diseases and upper GIT symptoms co exist.