[Successful medical treatment of post-traumatic tracheo-oesophageal fistulae (author's transl)].

Tracheo-oesophageal fistulae secondary to closed traumatic lesions of the thorax are rarely encountered, and only 38 cases have been reported in the published literature. The causal accident is usually perforation due to steering wheel projection or a crushing injury in a young subject (77% less than 30 years old) with a supple thorax, and parietal lesions are rarely observed. The initial lesion is rupture of the trachea with oesophageal confusion, usually above the level of the carina. The only diagnostic clinical sign is cough on swallowing, and diagnosis suspected on bronchoscopy is confirmed by radiological examination with a contrast medium. Urgent surgical treatment is necessary to repair the tracheal lesion. Secondary disunion may be observed (8--34). The particular characteristic of the cases presently reported was the secondary formation of a fistula after tracheal repair. Direct enteral feeding led to closure of the communication in 6 weeks.