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Review
. 2021;89(6):811-817.
doi: 10.24875/CIRU.20000730.

Surgical approach for iatrogenic tracheoesophageal fistula. Case report and literature review

Jesús F Nagore-Ancona  1 , Arturo Acosta-Martínez  1 , Josúe A González-Luna  1 , Jesús A Martín-Pérez  1 , Ana L Sánchez-Baltazar  1 , Luisana Perna-Lozada  1
Affiliations
Free article
Review

Surgical approach for iatrogenic tracheoesophageal fistula. Case report and literature review

Jesús F Nagore-Ancona et al. Cir Cir. 2021.
Free article

Abstract
in English, Spanish

Background: Post-intubation tracheoesophageal fistula is a severe complication in long-term mechanical ventilation patients with possible fatal consequences.

Objective: To describe a case of post-intubation tracheoesophageal fistula and its surgical management. In addition, a brief literature review was effectuated.

Case report: 45-year-old female, suffers ischemic stroke with progressive neurological damage that requires long-term mechanical ventilation. During endoscopic gastrostomy tracheoesophageal fistula is shown.

Results: Undergoes surgery for esophageal repair and tracheal resection, through cervicosternotomy. Unfortunately died in the immediate postoperative period.

Conclusions: This complex pathology requires structured protocols for its prevention in patients in whom long-term mechanical ventilation is expected.

Antecedentes: La fístula traqueoesofágica es una complicación en pacientes con ventilación mecánica prolongada. La contaminación pulmonar permanente puede ser grave, con evolución fatal.

Objetivo: Describir un caso de fístula traqueoesofágica posintubación y hacer una breve revisión de la literatura.

Caso clínico: Mujer de 45 años que sufre un evento cerebrovascular isquémico que condiciona deterioro neurológico progresivo, ameritando ventilación mecánica prolongada. Durante la gastrostomía endoscópica se evidencia una fístula.

Resultados: Intervenida quirúrgicamente para reparación esofágica y resección traqueal mediante cervicoesternotomía, lamentablemente fallece en el posoperatorio inmediato.

Conclusiones: Esta patología es compleja. Deben implementarse protocolos enfocados en su prevención en pacientes en quienes se espera una ventilación mecánica prolongada.

Keywords: Enfermedades de la tráquea; Esternotomía media; Fístula traqueoesofágica; Mechanical ventilation; Median sternotomy; Tracheal diseases; Tracheoesophageal fistula; Ventilación mecánica.

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