Title: Surgical treatment of tracheoesophageal fistula in a patient with severe acute respiratory syndrome complicated with extensive pulmonary fibrosis.

POPLINE Document Number: 277008

Author(s):

Lee JM
Lee PL
Kuo SW
Hwang JJ
Lee YC

Source citation:

Journal of Formosan Medical Association, 2004;103:932-934.

Abstract:

Tracheoesophageal fistula is an uncommon complication usually associated with chronic usage of ventilator and pressure necrosis of the tracheoesophageal wall. A 56-year-old female patient with severe acute respiratory syndrome (SARS) with tracheoesophageal fistula is reported. She was intubated for ventilatory support 3 days after admission because of progressive respiratory distress. Methylprednisolone pulse therapy followed by a maintenance dosage was given due to persistence of bilateral pulmonary fibrosis. Thirty three days after admission, she underwent tracheostomy because of difficult in weaning from the ventilator. Ten days after tracheostomy, she developed tracheoesophageal fistula, which was confirmed by bronchoscopy and panendoscopy. Tracheal resection and primary repair for the esophageal defect was performed via a cervical incision combined with partial sternotomy. She was weaned from the ventilator soon after the surgery and discharged 34 days after the operation. In SARS patients with persistent pulmonary fibrosis and under prolonged corticosteroid treatment, special care should be given to avoid intubation-related tracheal injury during the period of ventilatory support. The tracheoesophageal fistula, once developed, can be repaired in a single stage after improvement of the nutritional status. (author's)

Keywords:

Taiwan
Research Report
Case Studies
Clinical Research
Women in Development
Fistula
Respiratory Insufficiency
Complications
Pulmonary Effects
Asia, Eastern
Asia
Developed Countries
Studies
Research Methodology
Economic Development
Economic Factors
Diseases
Physiology
Biology