Tracheoesophageal Fistula as a Late Complication of Tracheostomy: A Case Report

Introduction: Tracheoesophageal fistula is the possible complication of tracheostomy with a rare occurrence, with less than 1% incidence, but it should be suspected, diagnosed, and treated quickly to prevent an unfavorable evolution.

Objective: The study aims to evaluate the clinical features of tracheoesophageal fistula as a complication of prolonged traqueostomia.

Resumed report: A 1-year-old patient, admitted in the intensive care unit (ICU) of Hospital de Reabilitação de Anomalias Craniofaciais da USP (HRAC), Baurú city, intubated and with nasogastric tube from birth, with recurrent pneumonia clinical and respiratory failure requiring tracheostomy 3 months later. The patient evolved with abundant saliva secretion from tracheostoma, confirmed by tracheoscopy. The clinical evaluation showed leukocytosis, chronic diarrhea, and change in healing of tracheostoma and gastrostoma. During the investigation, was observed mediastinal mass, with biopsy of lymph node suggestive of lymphoma. Because of comorbidities, surgical correction of tracheoesophageal fistula or biopsy of mediastinal mass in a tertiary hospital was not possible, and the patient died by decompensated respiratory failure.

Conclusion: This case leads us to consider not only early suspicion, but also the need for intervention as soon as possible, and thus less morbidity of the patient.

Keywords: tracheostomy, complications, tracheal fistula.