1/43. Successful long-term endoscopic closure of a recurrent tracheoesophageal fistula with fibrin glue in a child.We present an unusual case of recurrent tracheoesophageal fistula after primary surgical repair of congenital esophageal atresia. Traditionally, this disorder has required open-surgical correction, but successful endoscopic closure of these fistulas has been reported. This case report describes our experience using fibrin glue, applied endoscopically in a 6-year-old child, with encouraging long-term results 4 years after treatment.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
2/43. Acquired tracheoesophageal fistula in critically ill patients.Acquired benign tracheoesophageal fistula (TEF) is an infrequent complication of prolonged intubation and tracheostomy. Not infrequently, it is associated with severe circumferential malacia of the trachea and a need for concomitant correction of both. Controversy exists as to whether this should be performed in a single-stage or a 2-stage procedure. Four patients with acquired TEF underwent operation in a tertiary referral medical center between 1995 and 1997. The operations were performed through either an anterior (3) or a lateral (1) neck approach. Three patients underwent closure of the fistula with tracheal resection and anastomosis in a single stage and are doing well. One patient with complete subglottic stenosis underwent closure of the TEF and was planned for tracheal reconstruction in a second stage. This patient died in the early postoperative period. The complications included aspiration of blood leading to pneumonia (2), spontaneously resolving pneumomediastinum (1), subcutaneous emphysema (2), and cardiac arrhythmia ( 1). Residual fistula, noted in 1 patient, was treated conservatively and resolved spontaneously within several weeks. We conclude that acquired TEF is amenable to repair through a cervical approach. A single-stage correction of the TEF with reconstruction of the trachea is suitable and successful in most patients. Several stages seem justified when concurrent laryngotracheal reconstruction is needed.- - - - - - - - - - ranking = 0.4keywords = closure (Clic here for more details about this article) |
3/43. Benign tracheo-neo-esophageal fistulas after subtotal esophagectomy.BACKGROUND: Benign tracheo-neo-esophageal fistulas after esophagectomy are rare and treatment can be challenging. They can result from perioperative tracheal injury or various postoperative complications. methods: charts of 6 patients with a benign tracheoneo-esophageal fistula after subtotal esophagectomy treated in this institution between July 1993 and August 1999 were analyzed. RESULTS: Three men and 3 women (median age 61 years) developed a fistula after subtotal esophagectomy. Symptoms varied from mild swallowing difficulties to aspiration pneumonia and mediastinitis. Two patients with mild symptoms were treated conservatively. In 1 patient a long fistula was partly excised through the neck. In 3 patients the gastric tube was excluded or excised, with surgical closure of the tracheal defect. The alimentary tract was reconstructed by colonic interposition. There were no major complications. After a median follow-up of 1.6 years, all fistulas were closed. All patients were capable of sufficient oral intake. CONCLUSIONS: A benign tracheo-neo-esophageal fistula after esophagectomy is a rare, but serious complication. Site and size of the fistula, together with the severity of symptoms, should dictate management.- - - - - - - - - - ranking = 0.2keywords = closure (Clic here for more details about this article) |
4/43. Congenital bronchoesophageal fistula and tracheoesophageal fistula with esophageal atresia.A case of initial esophageal atresia and tracheoesophageal fistula in a female newborn, later complicated by pneumonia and a second bronchoesophageal fistula, is reported. She was treated surgically by closure of the tracheoesophageal fistula and by end-to-end esophago-esophageal anastomosis. An esophagram at 1 month of age was normal. Three months later she developed severe, persistent right lower lobe pneumonia that required intensive antibiotic therapy and respiratory support. Esophagography was repeated and revealed a second fistula between the right main-stem bronchus and the lower esophagus. The bronchoesophageal fistula was repaired, and a right lower lobectomy was performed. Postoperative recovery was uncomplicated. Histologic examination indicated that the fistula was congenital in origin. To the best of our knowledge, this is the first reported case of a congenital bronchoesophageal fistula coexisting with a tracheoesophageal fistula and esophageal atresia.- - - - - - - - - - ranking = 0.2keywords = closure (Clic here for more details about this article) |
5/43. 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.- - - - - - - - - - ranking = 0.2keywords = closure (Clic here for more details about this article) |
6/43. Rare case of spontaneous closure of tracheo-esophageal fistula secondary to disc battery ingestion.Accidental ingestion of foreign bodies by children is not an uncommon event. Now a day, with increasing accessibility of electronic toys and devices to the children, ingestion of miniature size batteries is on the rise [J. Am. Med. Assoc., 249, (1983), 2495]. Unlike the usual foreign bodies, ingestion of button alkaline batteries may be associated with serious complications if not removed early [Am. J. Otolaryngol., 21 (2000) 333]. We report a rare and interesting case, in which a child developed tracheo-esopbageal fistula secondary to disc battery ingestion, and importantly, its conservative management resulting in its spontaneous closure.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
7/43. Endoscopic obliteration of a recurrent tracheoesophageal fistula with enbucrilate and polidocanol in a child.We present a difficult case of a recurrent tracheoesophageal fistula following primary surgical repair of esophageal atresia. After four unsuccessful attempts to close the fistula, which included three thoracotomies and one endoscopic obliteration using fibrin glue, successful recurrent tracheoesophageal fistula closure was attained with the endoscopic application of enbucrilate (Histoacrylate) combined with polidocanol. enbucrilate was applied into the lumen of the fistula by bronchoscopy, and polidocanol (Sclerovein) was injected into the esophageal submucosa around the fistula by esophagoscopy. Three years after this treatment, the fistula remains apparently closed.- - - - - - - - - - ranking = 0.2keywords = closure (Clic here for more details about this article) |
8/43. life threatening subcutaneous emphysema following surgical repair of tracheocutaneous fistula.A 9-year-old male child posted for closure of tracheocutaneous fistula developed extensive subcutaneous emphysema resulting in acute respiratory distress immediately after transfer to recovery room. The clinical management, precautions and other complications of closure of tracheocutaneous fistula are discussed.- - - - - - - - - - ranking = 0.4keywords = closure (Clic here for more details about this article) |
9/43. A technique using a rectus abdominis muscle flap in the treatment of adult congenital tracheoesophageal fistulas.The authors successfully treated an adult with congenital tracheoesophageal fistula (TEF) Gross-C type by the addition of an effective pedicled muscle flap. This patient had undergone 2 thoracotomies when he was an infant at another hospital; however, the fistula recurred. After transection and closure of the fistula, a right rectus abdominis muscle flap between the 2 stumps was interposed. The current case followed a favorable postoperative course; neither fistula nor abdominal hernia occurred.- - - - - - - - - - ranking = 0.2keywords = closure (Clic here for more details about this article) |
10/43. Esophagotracheal fistula after lithium disc battery ingestion successfully treated with hyperbaric oxygen therapy.We report a case of a 12-month-old child who acquired an esophagotracheal fistula of 5 mm in diameter after an ingested lithium disc battery impaction. Failure to recognize foreign body on chest x-rays resulted in a delay of 28 days in establishing the diagnosis. Feeding via nasogastric tube and hyperbaric oxygen treatment (HBOT) resulted in a complete closure of the fistula after 17 HBOT 60 min sessions at 2.2 bars.- - - - - - - - - - ranking = 0.2keywords = closure (Clic here for more details about this article) |
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