2013 Volume 64 Issue 3 Pages 219-223
We experienced a case of tracheoesophageal fistula associated with tracheal stenosis after tracheostomy. The case was a 15-year-old male. Tracheostomy was performed for disturbance of consciousness after a traffic accident. The tracheostomy cannula was removed, but because of repeated pneumonia, swallowing training had been carried out for suspected aspiration. Tracheal stenosis was noted by CT, but tracheoesophageal fistula and aspiration were absent by esophagram. We performed tracheal stenosis removal and T-tube retention, and during this surgery a tracheoesophageal fistula was observed in the narrow segment of the trachea. The left wall and posterior wall of the trachea were exfoliated from the surrounding tissues, and the local flap was translocated to between the trachea and esophagus so as to cover the site of the tracheoesophageal fistula. Suture of the fistula was carried out again after the surgery. The T-tube was removed after 1 year. Tracheal stenosis and pneumonia did not recur.
Tracheoesophageal fistula after tracheostomy is relatively rare. If aspiration is suspected in the history, we should plan surgery for tracheal stenosis assuming the presence of a tracheoesophageal fistula even if there are no positive findings.
