Tracheoesophageal fistula after blunt chest trauma

Reed, William J.; Doyle, S.; Aprahamian, Charles

doi:10.1016/0003-4975(94)00964-9

Cited by 39 publications

(45 citation statements)

References 35 publications

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“…The tear is usually linear in the vertical plane of the esophagus and trachea, and at the same anatomic level. Therefore, the TEF usually presents at or immediately above the carina, and Reed et al [1] reported that in only five cases, the TEF extended to the left, right, or both main bronchi, as seen in our patient. This extended tear of the bronchial tree may lead to an incomplete adhesion between the injured bronchial tree and esophagus.…”

Section: Discussionmentioning

confidence: 88%

“…There are various methods of introducing healthy viable tissue to patch repair. However, a pedicled intercostal muscle flap [1,7] as used in the present case is favorable in most cases.…”

Section: Discussionmentioning

confidence: 96%

“…Nonoperative management carries a mortality rate of 80%, whereas the operative mortality rate is only 9.3% [1]. One controversial point involves the decision for primary closure versus esophageal exclusion and diversion.…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous closure of a TEF is extremely uncommon [1], and surgical therapy should be planned as soon as the diagnosis has been confirmed. There are several differing options to repair TEF.…”

Section: Introductionmentioning

confidence: 99%

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Tracheoesophageal Fistula with Severe Mediastinitis Following Blunt Chest Trauma

et al. 2005

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European Journal of Trauma Ab stractTracheoesophageal fistula (TEF) following nonpenetrating injury is a very rare traumatic condition but serious complication that needs an immediate surgical intervention after making an accurate diagnosis. A case of TEF with severe mediastinitis that is rarely accompanied with TEF is reported. An 18-year-old man who had a traffic accident was admitted to the intensive care unit. After 2 days following admission and intubation, bile juice was suctioned from the trachea. TEF was suspected and promptly confirmed by contrast esophagogram. The patient was taken to surgery and underwent a right posterolateral thoracotomy. The tracheal defect was repaired by primary suture with reinforcement of the pedicled intercostal muscle flap and esophageal exclusion and diversion with drainage was performed because of severe mediastinitis. A second-stage esophageal reconstruction with a right colon conduit was performed when he was completely stabilized in the aspects of infection, nutrition and respiration. His postoperative course was uneventful.

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Section: Discussionmentioning

confidence: 88%

“…There are various methods of introducing healthy viable tissue to patch repair. However, a pedicled intercostal muscle flap [1,7] as used in the present case is favorable in most cases.…”

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tracheoesophageal Fistula with Severe Mediastinitis Following Blunt Chest Trauma

et al. 2005

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“…By far, the most common cause in the present day is a complication of prolonged mechanical ventilation [3]. Other, less common causes include iatrogenic injuries [4], trauma [5], prior tracheal or esophageal surgery [6,7], indwelling stents [8], granulomatous mediastinal infections [9], and AIDS [10]. The pathogenesis of postintubation TEF is believed to be due to pressure necrosis of the tracheal and esophageal walls from the inflated endotracheal tube cuff.…”

Section: Opinion Statementmentioning

confidence: 98%

Management of tracheoesophageal fistulas in adults

Chauhan

Long

2004

Curr Treat Options Gastro

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The approach to treatment of adult patients with tracheoesophageal fistulas depends on whether the fistula is congenital or acquired in origin. Most adults have acquired tracheoesophageal fistulas, and treatment depends on whether the fistula is a result of a benign process or a malignancy, with the latter usually primary esophageal cancer. For patients with benign tracheoesophageal fistulas, treatment is almost always initially supportive followed by definitive surgical correction. In general, depending on the size and location of the tracheal aspect of the fistula, surgical therapy involves primary repair of the fistula and, if necessary, resection and reconstruction of the trachea. For patients with malignant tracheoesophageal fistulas, treatment depends on whether the patient is resectable and/or medically fit for surgical therapy. However, most patients with malignant trach-eoesophageal fistulas have advanced disease and can only be treated with palliative measures. The current standard of palliative therapy for patients with malignant tracheoesophageal fistulas is the endoscopic or radiologic placement of covered self-expanding metallic stents (SEMS), which allow closure of the fistula. All three types of commercially available covered SEMS have been used in this capacity with success. Other, less common treatment options for selected patients with malignant tracheoesophageal fistulas include chemotherapy and radiation, surgical bypass, esophageal exclusion, and fistula resection and repair.

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