1993 Volume 7 Issue 5 Pages 580-585
A 17-year-old male was involved in a motorcycle accident on June 6, 1989. Three days later, he developed a cough after swallowing.
An esophagogram confirmed tracheoesophageal fistula. He underwent primary treatment (gastrostomy, etc.) and was referred to us for radical operation on postinjury day 63.
A right postero-lateral thoracotomy was performed through the fourth intercostal space. The fistula (35 mm × 8 mm) was located just above the carina between the membranous portion of the trachea and the anterior wall of the esophagus. The fistula was divided, the trachea was closed with a single layer of interrupted 4-0 PDS, and the esophagus was closed in two layers with interrupted 3-0 vicryl sutures. A pedicled 4th intercostal muscle was interposed between the tracheal and esophageal suture lines to prevent recanalization.
The postoperative course was uneventful.
