Acquired tracheoesophageal fistula in an adult due to mango endocarp: a case report.

INTRODUCTION AND

IMPORTANCE

Tracheoesophageal fistulas (TEF) resulting from foreign body (FB) ingestion often present late, leading to delayed diagnosis. To the best of our knowledge, this is the first reported case of TEF caused by the accidental ingestion of a mango endocarp in the English literature.

CASE PRESENTATION: A 27-year-old female was referred for persistent cough for 4 months, following accidental ingestion of a mango endocarp. She initially complained of short-lived throat pain, foreign body sensation, and difficulty swallowing. At our facility, imaging revealed a TEF at the T1 vertebral level. Intraoperative localization was achieved with a bronchoscope and the fistulous tract was dissected and excised. The esophagus and trachea were repaired in two and one layers, respectively, and a sternohyoid flap was mobilized to buttress the repairs. She had a smooth recovery, with normal swallowing and voice preservation, and remains asymptomatic at 2 years.

CLINICAL DISCUSSION: Although the majority of esophageal FBs are uncomplicated, delayed presentations can lead to severe complications like bleeding, perforation, or TEF. In our case, the initial symptoms of throat pain and mild dysphagia might have been the result of an initial laceration by the mango endocarp or impaction resulting in ulceration. The ulcer might have eroded deep into the trachea causing a fistula due to delay in seeking care.

CONCLUSION

Mango endocarp ingestion can be a rare cause of TEF in adults and has to be considered in an appropriate setting.