Tracheoesophageal fistula developing postintubation

Yıl 2013, Cilt: 21 Sayı: 2, - , 01.08.2013

Erol Çakmak Hilmi Ataseven Özlem Yönem Köksal Bilgen Hakan Güzel

https://doi.org/10.17940/endoskopi.74807

Öz

Tracheoesophageal fistula, congenital or acquired, is a connection between the esophagus and trachea. Acquired tracheoesophageal fistula is divided as malignant and nonmalignant. The most common cause of acquired tracheoesophageal fistula is malignancy, while the most common cause of nonmalignant tracheoesophageal fistula is trauma associated with endotracheal cuff during prolonged mechanic ventilation. When the pressure in an endotracheal cuff balloon exceeds the capillary perfusion pressure, it causes ischemia and necrosis in the local tracheal mucosa. Our patient was a 33-year-old male with tracheoesophageal fistula developing after long-term endotracheal intubation for organic phosphorus poisoning.

Anahtar Kelimeler

Postintubation tracheoesophageal fistula, trachea, esophagus

Postentübasyon sonrası gelişen trakea-özofageal fistül

Öz

Trakea-özofageal fistül, konjenital veya akkiz olan özofagus ve trakea arasında bağlantı olmasıdır. Akkiz trakea-özofageal fistül malign ve nonmalign olmak üzere ikiye ayrılır. Akkiz trakea-özofageal fistül en sık nedeni malignitedir. Non malign trakea-özofageal fistülün en sık nedeni ise uzamış mekanik ventilasyona bağlı endotrakeal kaf ile ilişkili travmadır. Endotrakeal kaf basıncı, ortalama doku kapiller perfüzyon basıncı geçtiğinde lokal trakea mukozasında iskemi ve nekroza neden olur. Hastamız 33 yaşında erkek, organik fosfor zehirlenmesi sonrası uzun süreli endotrakeal entübasyon sonrası gelişen trakea-özofageal fistül idi.

Anahtar Kelimeler

Entübasyon sonrası trakea-özofageal fistül, trakea, özofagus

Kaynakça

• 1- Diddee R, Shaw IH. Acquired tracheo-oesophageal fistula in adults. Contin Educ Anaesth Crit Care Pain 2006; 6: 105-8.
• 2- Chauhan SS, Long JD. Management of tracheoesophageal fistulas in adults. Curr Treat Options Gastroenterol. 2004; 7: 31-40.
• 3- Marzelle J, Dartevelle P, Khalife J, et al. Surgical management of acquired post-intubation tracheo-oesophageal fistulas: 27 patients. Eur J Cardio- thoracic Surg 1989; 3: 499-502.
• 4- Abbey NC, Green DE, Cicale MJ. Massive tracheal necrosis complicating endotracheal intubation. Chest 1989; 95: 459-60.
• 5- Collier KP, Zubarik RS, Lewis JH. Tracheoesophageal fistula from an indwelling endotracheal tube balloon: a report of two cases and review. Gastrointest Endosc 2000; 51: 231-4.
• 6- Payne DK, Anderson WM, Romero MD, et al. Tracheoesophageal fistula formation in intubated patients. Risk factors and treatment with high- frequency jet ventilation. Chest 1990; 98: 161-4.
• 7- Couraud L, Ballester ML, Delaisement C. Acquired tracheoesophageal fistula and its management. Semin Thorac Cardiovasc Surg 1996; 8: 392-9.
• 8- Yakut M, Çınar K, İdilman R. Malign özofagus darlığı olgusunda multipl stent uygulaması. Endoskopi dergisi 2011; 19: 18-9.