Korean J Neurotrauma.  2013 Oct;9(2):146-149. 10.13004/kjnt.2013.9.2.146.

Tracheoesophageal Fistula: A Fatal Complication of Endotracheal Intubation

• Jeung SH
• Lee HJ
• Yi JS
• Yang JH
• Lee IW

• KMID: 2156118
• DOI: http://doi.org/10.13004/kjnt.2013.9.2.146

Abstract

Tracheoesophageal fistula (TEF) is a rare disease which develops as a result of congenital or acquired causes. We report on two TEF female stroke patients with associated endotracheal intubation. Endotracheal intubation was kept for 13-14 days because of decreased mentality by intracranial hemorrhage. Recurrent pneumonia was a predominant symptom. Computed tomography and bronchoscopy were used to diagnose TEF. Both patients expired by sepsis and recurrent pneumonia before definite TEF treatment. The excessive dilatation of the cuff balloon of the endotracheal tube was considered one of the main causes of TEF. Prevention is most important and early treatment is required in this fatal disease.

Keyword

Tracheoesophageal fistula; Endotracheal intubation; Pneumonia

MeSH Terms

Bronchoscopy
Dilatation
Female
Humans
Intracranial Hemorrhages
Intubation, Intratracheal*
Pneumonia
Rare Diseases
Sepsis
Stroke
Tracheoesophageal Fistula*

Figure

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  FIGURE 1. Chest radiogram checked 3 days after admission shows the excessively dilated cuff of the endotracheal intubation tube.

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  FIGURE 2. Tracheoesophageal fistula is seen between the esophagus and the trachea on neck computed tomography in case 1. The white dot is the Levin tube in the esophagus.

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  FIGURE 3. Tracheoesophageal fistula observed at 18 cm from incisor under endoscopic view in case 1. The upper lumen is the trachea and the lower lumen is the esophagus.

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  FIGURE 4. Tracheoesophageal fistula is seen between the esophagus and the trachea on neck computed tomography in case 2. The white dot is the Levin tube in the esophagus.

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  FIGURE 5. Universal cuff pressure instrument of the intubation tube.

Reference

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