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Acquired tracheoesophageal fistula following disc-battery ingestion: can we watch and wait?

Abstract：

:Acquired tracheoesophageal fistulas (TEF) are rare but dangerous complications of disc-battery ingestion. Management approaches include endoscopic or open surgical repair. Unfortunately, these procedures can be complicated by high rates of recurrent laryngeal nerve injury, tracheal stenosis, recurrent fistula and significant patient mortality. Thus, several authors have advocated the use of esophageal rest as conservative management of acquired TEF to permit closure by secondary intention. This study describes a patient with spontaneous closure of an acquired TEF following disc-battery ingestion. The late recurrence of the TEF following conservative management, and endoscopic and radiographic evidence of closure, illustrates the importance of long term evaluation before assuming fistula resolution. Practitioners must carefully weigh the risks and benefits before deciding surgical versus conservative management of TEF. An extended follow-up of at least 6 months should be instituted with a high index of suspicion if conservative management is utilized. Transtracheal repair using an imbricated suture technique is a good surgical option when conservative management fails.

journal_name

Int J Pediatr Otorhinolaryngol

journal_title

International journal of pediatric otorhinolaryngology

authors

Grisel JJ,Richter GT,Casper KA,Thompson DM

doi

10.1016/j.ijporl.2008.01.015

subject

Has Abstract

pub_date

2008-05-01 00:00:00

pages

699-706

issue

5

eissn

0165-5876

issn

1872-8464

pii

S0165-5876(08)00015-3

journal_volume

72

pub_type

杂志文章

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