A Rare Benign Bronchoesophageal Fistula Presenting in Adulthood: A Case Report
Bibliographic record
Abstract
We report a rare case of benign bronchoesophageal fistula (BEF) of the main left lung lower lobe bronchus associated with granulomatous disease. A 30-year-old male was repeatedly seen over a period of three years at our institution for vague abdominal and respiratory symptoms. He underwent chest radiograph, CT scan of the neck, modified barium swallow study, and multiple endoscopies and laryngoscopies without a definitive diagnosis. A diagnosis of bronchoesophageal fistula was made by single contrast esophagram when a fistulous tract was demonstrated between the esophagus and left lower lobe bronchus. Chest computed tomography scanning demonstrated the fistulous tract, but also showed multiple calcified mediastinal lymph nodes adjacent to the site of fistula, which were thought to be consistent with prior granulomatous disease, likely histoplasmosis which is endemic to our area. The patient was treated surgically, and the fistula, adhesions, and adherent calcified lymph node were all removed at the time of the procedure. The presence of histoplasmosis could not be confirmed, but is most likely the cause of this uncommon BEF presentation. In conclusion, this is a rare presentation of a benign, acquired broncho-esophageal fistula associated with fungal infection. doi:10.4021/jmc138w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".