Tracheoesophageal Fistula due to a Damaged Tracheal Stent

Abstract

We describe the management of a tracheoesophageal fistula due to a damaged tracheal stent, which was first inserted to treat tracheal stenosis. A 29-year-old woman with a history of treated epilepsy had a seizure and suffered from smoke inhalation during a fire. Breathing difficulties appeared and gradually worsened; consultation was obtained two years afterward. After undergoing a thorough examination, the patient was diagnosed with tracheal strangulation. A noncovered, metallic stent was inserted. When the patient was 37 years old, she was admitted to our hospital for the treatment of a tracheoesophageal fistula. We diagnosed it as a tracheoesophageal fistula due to the collapse of the damaged tracheal stent toward the esophageal side, and we decided to perform a mediastinal tracheostomy. Granulation may be formed in the circumference of a stent that has been present for a prolonged period, and removal of the stent may become difficult. This case suggests that insertion of a noncovered, metallic stent is contraindicated for a benign disease.

The Unexpected Formation of a Broncho-Esophageal Fistula of the Right Main Stem Bronchus Status Post Esophageal Stent Placement: A Case Report

“…In another case report by Kimura et al, although not a BEF, their team describes a patient found to have postprandial obstruction who developed a TEF. The collapse of the patient’s damaged tracheal stent towards the esophageal side was thought to be the cause of TEF [ 6 ]. The stent was removed, and the fistula was repaired.…”

Management of Tracheobronchial Injuries with Subcutaneous Emphysema

“…No positive end-expiratory pressure (PEEP) and low tidal volumes can be used in CM because airway pressure causes perforation in trachea 12,13 . Tracheal stents (TS) is now considered a better option in management of airway obstructions and in tracheobronchial injuries [14][15] . Evidences are available to using stunts in the management of posterior wall of TI 16 .…”

Tracheal injury characterized by subcutaneous emphysema and dyspnea after improper placement of a Sengstaken–Blakemore tube

“…[ 5 ] In this case, the patient's subcutaneous emphysema worsened while being treated with positive pressure ventilation. In recent years, the placement of tracheal stents has become a therapeutic option for the treatment of large airway obstructions, [ 6 , 7 ] tracheomalacia, [ 8 ] tracheoesophageal fistula, [ 9 ] tracheomediastinal fistula, [ 10 ] and airway compromise due to extrinsic compression. [ 6 , 11 , 12 ] There are also case reports of using treacheal stents to manage longitudinal tracheal injury of the posterior wall.…”