Anesthetic management of the complications of previously undiagnosed ingested foreign body in a pediatric patient

Abstract

A case of a previously undiagnosed ingested foreign body, subsequent acquired tracheoesophageal fistula and airway obstruction in a pediatric patient is described. We suggest that the capability to provide cardiopulmonary bypass was a key factor in this patient's survival.

Management of acquired tracheoesophageal fistula with various clinical presentations

“…The variety of etiologic causes and differences in location and size of the fistula lead to discrepancies in clinical presentation [4]. The onset can be either immediate with respiratory difficulty in addition to subcutaneous air, pneumothorax, and pneumomediastinum [10,12]; or it can be chronic with coughing, choking after ingestion, recurrent respiratory infections, and dysphagia [4,[13][14][15]. Increased tracheal secretions, air leak around the tube cuff, suctioning of gastric contents through the tracheotomy, abdominal distention, and air leakage from a nasogastric or gastrostomy tube are among the signs that should suggest the potential diagnosis of TEF [16,17].…”

Airway and ventilation management during repair of a large acquired tracheoesophageal fistula: the novel use of a readily available tool

“…Affected children may have delayed presentation despite many signs and symptoms such as dysphagia, dyspnea, choking, and pneumonia [15,16]. Disc battery ingestion requires urgent endoscopic removal under direct visualization with general anesthesia.…”