Rana Ramesh, Sapkota Rikesh, Shakya Binesh, Gautam Samir
Department of Internal Medicine, Gautam Buddha Community Heart Hospital, Butwal, Nepal.
Department of Anaesthesiology, Gautam Buddha Community Heart Hospital, Butwal, Nepal.
JNMA J Nepal Med Assoc. 2018 Nov-Dec;56(214):980-982. doi: 10.31729/jnma.3890.
Tracheoesophageal fistula is an abnormal communication between trachea and esophagus. Benign acquired types are rare with the incidence of less than 1%. Prolonged endotracheal intubation remains the most common cause. We are reporting a 28 years old female patient presented with chief complaint of a cough after each meal intake in the outpatient clinic. She had a recent history of admission in the intensive care unit with prolonged intubation (11 days). Her general physical examination, laboratory examination, and chest x-ray were normal. Esophagogastroscopy was performed and revealed communication between upper esophagus and trachea approximately at 14-17cm embedded in longitudinal mucosal folds of the esophagus. She was referred to the higher center for surgical repair. Though, a rare complication, high suspicion is necessary to accurately diagnose the disease in a patient with the history of prolonged intubation. Keywords: case report; endotracheal intubation; mechanical ventilation; tracheoesophageal fistula.
气管食管瘘是气管与食管之间的异常通道。良性后天性类型较为罕见,发病率低于1%。长时间气管插管仍然是最常见的原因。我们报告一名28岁女性患者,在门诊以每餐进食后咳嗽为主诉就诊。她近期有在重症监护病房长时间插管(11天)的病史。她的全身体格检查、实验室检查和胸部X线检查均正常。进行了食管胃镜检查,发现食管上段与气管之间在距食管起始部约14 - 17cm处相通,包埋于食管纵行黏膜皱襞内。她被转诊至上级中心进行手术修复。虽然这是一种罕见的并发症,但对于有长时间插管病史的患者,高度怀疑对于准确诊断该病很有必要。关键词:病例报告;气管插管;机械通气;气管食管瘘