Tuberculous oesophagopleural fistula.

Hydropneumothorax complicating to oesophagopleural and broncho-oesophageal fistula is an unusual presentation and is reported in literature as separate clinical entities. Here we present a case of hydropneumothorax with both oesophagopleural and broncho-oesophageal fistula of tuberculous aetiology occurring simultaneously in the same patient. Oesophagopleural fistula was suspected clinically by colour of pleural fluid. Subsequent barium swallow demonstrated leak of contrast material from oesophagus into pleural cavity. Later on, computed tomography of chest with oral contrast confirmed communication of oesophagus with both right pleural cavity and right main bronchus. The fistulous connection between these structures appeared to be due to tuberculous mediastinal lymphadenopathy as evident on CT thorax.