Sealing of a Tracheoesophageal Fistula Using a Sengstaken-Blakemore Tube for Mechanical Ventilation During General Anesthesia

Abstract

A 78-yr-old man was admitted to our hospital because of repeated episodes of pneumonia. Both fiberoptic bronchoscopy and esophagoscopy revealed a large tracheoesophageal fistula and protrusion of the metal stent from the esophagus into the trachea. Placement of a Dumon stent was planned for sealing this fistula under general anesthesia. Anesthetic management is difficult because of the care needed to prevent aspiration of esophageal contents and diversion of oxygen through the fistula into the stomach from the trachea when patients are under mechanical ventilation. Our method of sealing a large tracheoesophageal fistula with a Sengstaken-Blakemore tube was performed successfully.

Bronchoesophageal Fistula Stenting Using High-Frequency Jet Ventilation and Underwater Seal Gastrostomy Tube Drainage

“…More complex fistulas have been managed successfully with bilateral endobronchial intubation [ 14 ], extracorporeal membrane oxygenation [ 15 ], and cardiopulmonary bypass [ 16 ]. Some authors reported sealing the fistula prior to the intervention, using a modified esophageal balloon [ 17 ], or a Sengstaken–Blakemore tube [ 18 ]. Garg et al [ 19 ] reported two cases in children where they sealed the TEF using Fogarty and Foley catheter.…”