Tracheoesophageal Fistula Secondary to Tuberculosis: A Case Report

Abstract

A tracheoesophageal fistula (TEF) is a pathological connection between the trachea and esophagus. Infectious diseases rarely lead to TEF, and tuberculosis is the most common cause of TEF among all infectious causes. A 78-year-old male patient under examination for esophageal malignancy at the gastroenterology service, and who was expected to undergo an endoscopic biopsy, was diagnosed with aspiration pneumonia after complaints of dyspnea and coughing after liquid intake, and was transferred to chest diseases clinic. TEF was identified from a bronchoscopy. Mycobacterium tuberculosis DNA was isolated during a bronchial aspiration. An endoscopic biopsy, performed after esophageal malignancy was suspected, gave the result of a granulomatous reaction. The patient was diagnosed with tuberculosisinduced TEF. Anti-tuberculosis treatment was initiated, and a tracheal Y stent was fitted. In this article we present a rare case in which a TEF emerged secondary to tuberculosis, and suggest that tuberculosis may be a cause of TEF. It is advised that before starting invasive surgical TEF treatment, it is essential to take the necessary precautions.

A Rare Case of Conservative Management of Multiple Aerodigestive Fistulas in a Patient

“…Our patient with tubercular fistulas did not have clinical features of aspiration, probably because despite having multiple fistulas, the fistulous openings were smaller (less than 5 mm). Therefore, it was decided that the patient did not require primary defect closure with the help of clip, stent etc., either endoscopically or surgically, as is often described in available literature [ 6 , 9 , 10 ]. Endoscopic or surgical correction became necessary if the size of the defect is large (more than 5 mm) or patient has recurrent infection or sepsis because of aspiration.…”