Iatrogenic esophago-tracheal fistula: challenges in diagnosis and management

World J Gastroenterol. 2013 Jan 28;19(4):594-6. doi: 10.3748/wjg.v19.i4.594.

Abstract

Esophageo-tracheal fistula is a rare condition, and in most cases such fistulas are caused by malignant disease or emergency endotracheal intubation. A case where a wrapped tablet produced a fistula between the esophagus and trachea is described. The patient is a male born in 1938 who swallowed a tablet without unwrapping it. The patient was treated with self-expanding metal stents (SEMS), but closure of the fistula was not achieved. Different examinations and treatment options are discussed. Surgical treatment for this condition has demonstrated considerable mortality and morbidity. In some cases closure of the fistula can be achieved by use of SEMS. Although we advise treatment of such cases with SEMS, in some cases treatment with stents will prove troublesome and the risk/benefit analysis will have to be reevaluated.

Keywords: Esophageo-tracheal fistula; Iatrogenic; Percutaneous endoscopic gastrotomy; Stenting; Surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bronchoscopy
  • Deglutition
  • Drug Packaging*
  • Esophageal Fistula* / diagnosis
  • Esophageal Fistula* / etiology
  • Esophageal Fistula* / therapy
  • Esophagoscopy / instrumentation*
  • Foreign Bodies*
  • Humans
  • Iatrogenic Disease*
  • Male
  • Predictive Value of Tests
  • Respiratory Tract Fistula* / diagnosis
  • Respiratory Tract Fistula* / etiology
  • Respiratory Tract Fistula* / therapy
  • Stents*
  • Tomography, X-Ray Computed
  • Tracheal Diseases* / diagnosis
  • Tracheal Diseases* / etiology
  • Tracheal Diseases* / therapy
  • Treatment Outcome