A rare case of acquired tracheo-esophageal fistula in adult

Abstract

Acquired trachea-esophageal fistula (TEF) is a rare condition caused by cuffed tracheal tube, surgical trauma and blunt injuries. Surgical approach for the treatment is successful in surgical units with specialized TEF surgery. Herein, we presented such a rare case of post intubation acquired TEF in a 23 year old female patient who presented with cough and regurgitation of food 7 days after extubation. Patient had history of organophosphate poison ingestion after which she was intubated in emergency room and kept on mechanical ventilation for 11 days. Upper gastrointestinal endoscopy, fibre optic bronchoscopy and computed tomography scan of neck and chest revealed the presence of TEF, 2.5 cm below glottis. Patient was managed with elective single step surgical approach after which patient recovered well. Fistula resection with crico-tracheal anastomosis with primary closure of esophageal defect and suture line buttressed using strap muscle flap cover was done.