A lung abscess combined with mediastinal air shadow

A 55-year-old-female was admitted for the evaluation of mass shadow on chest film. She complained of fever, chilling, cough, and whitish sputum. She did not give any history of choking or coughing when she ate. The chest CT showed lung abscess in right lower lobe with extension of infiltration and air shadow in mediastinum. The esophagoscopy and esophagography were performed to find the cause of mediastinal infiltration, and bronchoesophageal fistula was detected in esophagography. The patient complained of severe chilling and febrile sensation after esophagography, mediastinitis aggravated by thin barium was suggested clinically. So, surgical drainage of lung abscess and thin barium was done urgently. One month after operation, follow-up of esophagoscopy and esophagography were done, the bronchoesophageal fistula was not detected.