Tracheoesophageal Fistula following Endotracheal Intubation for Organophosphorus Poisoning

Abstract

Tracheoesophageal fistula (TEF) is an abnormal communication between the trachea and esophagus. Iatrogenic TEF can be due to endotracheal intubation, rigid bronchoscopy or tracheostomy. Tracheostomy tube cuff volumes and pressures require constant monitoring to avoid tracheal injury. Acquired TEF which occurs after prolonged intubation, usually develops after 15-200 days of mechanical ventilation. We report a case of a large TEF secondary to endotracheal intubation for organophosphorus poison-induced respiratory failure. Patient presented with dysphagia and recurrent aspiration pneumonia after extubation. She underwent trachea-esophageal fistulectomy and closure with a sternocleidomastoid muscle flap.