Tracheoesophageal fistula secondary to chemical trauma: is there a place for planned conservative management?

Abstract

Objective: We present a unique case in which closure of a large tracheoesophageal fistula was achieved with planned conservative management.

Method: The literature was reviewed for other documented cases of spontaneous closure of traumatic tracheoesophageal fistula.

Results: Acquired tracheoesophageal fistula may result secondary to a chemical burn from an alkaline disc battery impacted in the oesophagus, particularly when the presentation, and thus diagnosis, are delayed. This condition is rare. The majority of such cases occur in children, and are conventionally managed with surgical repair. We found only three previously reported cases in which conservative management was attempted.

Conclusion: Non-interventional management should be tried initially for the management of paediatric acquired tracheoesophageal fistula, to permit closure by secondary intention.