Introduction:
Tracheoesophageal fistula (TEF) is a pathological entity characterized by the presence
of an abnormal connection between the trachea & the esophagus. Apart from the congenital
form, acquired TEF most commonly occurs following prolonged intubation incidence being
0.3 to 3% in patients with prolonged intubation. Most cases of TEF due to prolonged
intubation are associated with laryngotracheal stenosis (LTS). Management of TEF and
LTS in a single sitting is challenging.
Material and Methods:
60 patients who presented with LTS in the department of Otorhinolaryngology at the
J.S.S Medical College and Hospital, Mysore, India during of period of January 2013
-December 2016. Out of 60 patients 7 (11.7%) had TEF. Five patients underwent TEF
repair with T-tube insertion and 1 patient underwent only TEF repair. All patients
were followed up for 6 – 10months.
Results:
Here we present a series of seven cases of TEF following prolonged intubation associated
with LTS wherein, five patients were males and two were females. The age group of
the patients ranged from 22 to 60 years; mean age being 34 years. Duration of intubation
ranged between 12 to 20 days with a mean of 14.85 days. Five patients underwent TEF
repair with T-tube insertion and 1 patient underwent only TEF repair. All patients
were followed up for 6 – 10months. All 5 patients with T-tube were removed in 4 to
6 months' time.
Conclusion:
All patients presenting with breathing difficulty following prolonged intubation should
be investigated for TEF along with LTS. So high index of clinical suspicion is required
for early diagnosis and treatment of TEF presenting with LTS.
Key Words:
Tracheoesophageal fistula, laryngotracheal stenosis, prolonged intubation.
