Review of Tracheo-Esophageal Fistula Associated with Endotracheal Intubation

Mooty, R. Clark; Rath, Paul A.; Self, Michael; Dunn, Erica H.; Mangram, Alicia

doi:10.1016/j.jsurg.2007.05.004

Cited by 30 publications

(21 citation statements)

References 17 publications

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“…96,97 Clinically, a tracheoesophageal fistula can be identified when food content is suctioned from the ETT or if the patient presents with coughing during feeding, recurrent aspiration pneumonia, positive cuff leak, or gastric distention. 98 Diagnosis can be confirmed with radiology studies, such as an esophagram or computed tomography scan, or instead confirmed with esophagoscopy and bronchoscopy. Once the diagnosis is established, surgical repair is required because spontaneous closure is rare.…”

Section: Larynxmentioning

confidence: 99%

Complications of Airway ManagementDiscussion

Pacheco-Lopez¹,

Berkow

Hillel³

et al. 2014

Respir Care

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Although endotracheal intubation is commonly performed in the hospital setting, it is not without risk. In this article, we review the impact of endotracheal intubation on airway injury by describing the acute and long-term sequelae of each of the most commonly injured anatomic sites along the respiratory tract, including the nasal cavity, oral cavity, oropharynx, larynx, and trachea. Injuries covered include nasoseptal injury, tongue injury, dental injury, mucosal lacerations, vocal cord immobility, and laryngotracheal stenosis, as well as tracheomalacia, tracheoinnominate, and tracheoesophageal fistulas. We discuss the proposed mechanisms of tissue damage that relate to each and present their most common clinical manifestations, along with their respective diagnostic and management options. This article also includes a review of complications of airway management pertaining to video laryngoscopy and supraglottic airway devices. Finally, potential strategies to prevent intubation-associated injuries are outlined.

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Section: Larynxmentioning

confidence: 99%

Complications of Airway ManagementDiscussion

Pacheco-Lopez¹,

Berkow

Hillel³

et al. 2014

Respir Care

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“…The most common cause of acquired non-malignant tracheoesophageal fistulae is cuff-related tracheal injury in patients after prolonged endotracheal intubation or tracheostomy [45][46][47]. Patients are commonly elderly and malnourished.…”

Section: Esophageal Fistulaementioning

confidence: 99%

Uncommon acquired fistulae involving the digestive system: summary of data

Ashkenazi

Olsha

Kessel

et al. 2011

Eur J Trauma Emerg Surg

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“…The most common etiology of acquired nonmalignant TEF is necrotizing tracheitis due to prolonged intubation or tracheostomy, usually with overinflated (pressure [ 20 cm H 2 O) cuff, causing mucosal ischemia. Necrosis of the tracheal wall and neighboring esophagus may be substantial especially when nasogastric tube occupies the esophageal lumen [1]. Other factors associated with increased risk for TEF formation include excessive tube mobility, respiratory or esophageal infection, poor nutrition, advanced age, diabetes, anemia, hypotension and steroid treatment [2].…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography may be performed to identify the fistula, the surrounding soft tissue and essential structures. Bronchoscopy and esophagoscopy & Smadar Cohen-Atsmoni smadarit@hotmail.com allow direct visualization yet small fistulas might not be noticed [1]. Spontaneous healing of the TEF rarely occurs, and often surgical closure is indicated.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Occlusion of Tracheoesophageal Fistula in Ventilated Patients Using an Amplatzer Septal Occluder

Cohen-Atsmoni

Tamir

Avni

et al. 2015

Indian J Otolaryngol Head Neck Surg

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Acquired tracheoesophageal fistula (TEF) is a challenging, life threatening condition. It most commonly appears in critically ill patients requiring prolonged mechanical ventilation, who cannot withstand open neck or chest surgery. An endoscopic technique could be better tolerated by these patients. We present our experience using a cardiac Amplatzer ASD septal occluder for an endoscopic TEF repair in ventilation-dependent patients. Two high risk patients underwent the procedure under general anesthesia and close respiratory monitoring. In one patient the device was inserted through the trachea and in the other through the esophagus. In both cases fistula closure was achieved for different periods of time allowing the patients a temporary relief of symptoms. The procedure was well tolerated by the patients, and no significant adverse effect documented. The technique was successful as a temporary solution for unstable patients with TEFs and should be considered as a treatment modality for similar patients.

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Review of Tracheo-Esophageal Fistula Associated with Endotracheal Intubation

Cited by 30 publications

References 17 publications

Complications of Airway ManagementDiscussion

Complications of Airway ManagementDiscussion

Uncommon acquired fistulae involving the digestive system: summary of data

Endoscopic Occlusion of Tracheoesophageal Fistula in Ventilated Patients Using an Amplatzer Septal Occluder

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