Atypical presentation of tracheoesophageal fistula: immediate failure of ventilation via tracheostomy tube
Keywords:Prolonged ventilation, Tracheostomy, Tracheoesophageal fistula, Fibre optic bronchoscope
Tracheoesophageal fistula (TOF) is a rare complication of prolonged endotracheal intubation. Undiagnosed TOF during tracheostomy poses a risk of improper placement of tracheostomy tube and can lead to a potentially life-threatening situation. We report a case of an undiagnosed tracheoesophageal fistula during tracheostomy in a lady in which we encountered difficulty in placement of tracheostomy tube and were eventually able to cannulate the trachea with the help of a fibre optic bronchoscope.
Shen KR, Allen MS, Cassivi SD, Nichols FC. III, Wigle DA, Harmsen WS, et al. Surgical management of acquired nonmalignant tracheoesophageal and bronchoesophageal fistulae. Ann Thorac Surg. 2010;90:914–8.
Couraud L, Ballester MJ, Delaisement C. Acquired tracheoesophageal fistula and its management. Semin Thorac Cardiovasc Surg. 1996;8:392–9.
Marzelle J, Dartevelle P, Khalife J, Rojas-Miranda A, Chapelier A, Levasseur P. Surgical management of acquired postintubation TOF. Eur J Cardiothorac Surg. 1989;3:499-503.
Kastanos N, Estopa Miro R, Marin Perez A, Xaublet Mir A, Agusti-Vidal A. Laryngotracheal injury due to endotracheal intubation: Incidence, evolution, and predisposing factors.A long term study. Crit Care Med. 1983;11:362-7.
Paraschiv M. Tracheoesophageal fistula: A complication of prolonged tracheal intubation. J Med Life. 2014;7:516–21.