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Case Reports
. 2025 May 8;17(5):e83748.
doi: 10.7759/cureus.83748. eCollection 2025 May.

Post-intubation Tracheoesophageal Fistula Following Meningioma Excision: A Case Report and Literature Review

Nayef Alkhalil  1 , Abed AlRaouf Kawtharani  1 , Charles Nahas  2 , Antoine Abou Rached  3
Affiliations
Case Reports

Post-intubation Tracheoesophageal Fistula Following Meningioma Excision: A Case Report and Literature Review

Nayef Alkhalil et al. Cureus. .

Abstract

A tracheoesophageal fistula (TEF) is defined as a pathological connection between the trachea and the esophagus, leading to a spillover of oral and gastric secretions into the respiratory tract. TEF is either congenital or acquired. Congenital TEFs are rare in adults and are mainly associated with esophageal atresia that presents during infancy and childhood. However, much less is known about acquired TEF, which mainly affects the adult population. In adult patients, the majority of TEFs are acquired, with mediastinal malignancies, such as esophageal cancer and lung cancer, representing the etiology in over half the cases. The principal non-malignant causes of acquired TEFs include post-intubation trauma, chronic infections (e.g., tuberculosis), radiation injury, and post-surgical complications. Because they are rarely encountered in adults, TEFs are often difficult to diagnose and can present with nonspecific signs and symptoms. Endoscopic and surgical measures can be undertaken to prevent life-threatening complications and malnutrition. In this article, we report the case of a 68-year-old female patient who developed a large TEF after prolonged intubation in the ICU post undergoing a craniotomy for meningioma excision.

Keywords: coughing; iatrogenic complication; post-intubation complications; recurrent aspiration pneumonia; tracheo-esophageal fistula.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Axial view of non-enhanced CT Chest (Lung window) showing abnormal connection (yellow box) between the trachea (superior structure) and the esophagus (inferior structure), compatible with TEF
TEF: tracheoesophageal fistula
Figure 2
Figure 2. EGD view of the TEF (blue arrow) directly after bypassing the upper esophageal sphincter
The carina (bronchial bifurcation) is evident distally in the view (marked by the yellow star/asterisk). TEF: tracheoesophageal fistula; EGD: esophagogastroduodenoscopy
Figure 3
Figure 3. Bronchoscopic view of the TEF (pointed at by the blue arrow)
The tracheal carina is evident distally in the view (marked by the yellow star). TEF: tracheoesophageal fistula
See this image and copyright information in PMC

References

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