Case Report
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World J Gastroenterol. Jan 28, 2013; 19(4): 594-596
Published online Jan 28, 2013. doi: 10.3748/wjg.v19.i4.594
Iatrogenic esophago-tracheal fistula: Challenges in diagnosis and management
Øistein Hovde, Øyvind Haugen Lie, Per Arthur Johansson, Øystein Stubhaug, Egil Johnson, Bjørn Hofstad, Truls Hauge
Øistein Hovde, Øyvind Haugen Lie, Per Arthur Johansson, Øystein Stubhaug, Department of Gastroenterology/Internal Medicine, Innlandet Hospital Trust, 2819 Gjøvik, Norway
Egil Johnson, Department of Pediatric and Gastroenterological Surgery, Oslo University Hospital Ullevål, 0450 Oslo, Norway
Egil Johnson, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
Bjørn Hofstad, Truls Hauge, Department of Gastroenterology, Oslo University Hospital Ullevål, 0450 Oslo, Norway
Author contributions: All authors gave substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, and final approval of the version to be published.
Correspondence to: Øistein Hovde, MD, Department of Gastroenterology/Internal Medicine, Innlandet Hospital Trust, Gjøvik, Kyrre Grepps gt. 11, 2819 Gjøvik, Norway. oistein.hovde@sykehuset-innlandet.no
Telephone: +47-611-57002 Fax: +47- 611-57439
Received: April 12, 2012
Revised: July 3, 2012
Accepted: November 24, 2012
Published online: January 28, 2013
Abstract

Esophageo-tracheal fistula is a rare condition, and in most cases such fistulas are caused by malignant disease or emergency endotracheal intubation. A case where a wrapped tablet produced a fistula between the esophagus and trachea is described. The patient is a male born in 1938 who swallowed a tablet without unwrapping it. The patient was treated with self-expanding metal stents (SEMS), but closure of the fistula was not achieved. Different examinations and treatment options are discussed. Surgical treatment for this condition has demonstrated considerable mortality and morbidity. In some cases closure of the fistula can be achieved by use of SEMS. Although we advise treatment of such cases with SEMS, in some cases treatment with stents will prove troublesome and the risk/benefit analysis will have to be reevaluated.

Keywords: Esophageo-tracheal fistula, Stenting, Iatrogenic, Percutaneous endoscopic gastrotomy, Surgery