Tracheoesophageal fistula: case report and review of literature.

The case of a 44 year old woman with progressive postoperative dysphagia and food inhalations complicated by recurrent pulmonary infections, due to a tracheoesophageal fistula (TEF) is reported. Some months earlier, this woman had been operated for a cerebral aneurysm with hemiplegia and aphasia. For several months, pulmonary and feeding difficulties had been attributed to neurological status. Wide TEF was diagnosed by bronchoscopy, confirmed with fistulography. Surgical closure was performed: the oesophagus was sutured, and covered with fascia and a segment of the cervical trachea was resected with end-to-end anastomosis. Acquired nonmalignant TEF is an uncommon disorder with a high degree of morbidity and mortality. The etiology of those TEF is still unclear: traumatic intubation, elevated endotracheal tube cuff pressure, nasogastric tube, inflammation, poor general conditions,.... A better knowledge of the predisposing factors and physiopathology could decrease the number of acquired TEF.