Airway Manoeuvres during Anaesthetic Management of Adult Acquired Tracheo-Oesophageal Fistula

Abstract

Regardless of aetiology, acquired tracheo-oesophageal fistula (TEF) is a life-threatening condition due to the risk of pulmonary soiling and sepsis. Distorted airway anatomy below the glottis makes airway management challenging. We present the anaesthetic management for TEF repair in an adult male who developed fistula following organophosphorus poisoning. Maintaining optimum position of the endotracheal tube (ETT) during cross-field ventilation and ETT repositioning is crucial. For better understanding of the anaesthetic management for this relatively rare surgery, we have described airway management sequentially to coincide with different phases of surgical interventions.

Adult acquired carino-oesophageal fistula of malignancy: Anaesthetic considerations

“…An awake FOB-guided nasotracheal intubation is essential for bypassing more caudally located supracarinal TOFs. [ 6 ] Broncho-oesophageal fistulae necessitate a DLT for lung isolation and ventilation via the opposite bronchus. [ 2 7 ] Isolation of carino-oesophageal fistulae is largely unreported.…”