Tracheoesophageal Fistula with Tracheal Dilatation in a Patient with a Tracheostomy Using a Home Mechanical Ventilator.
- Author:
Byounghoon KIM
1
;
Min Sun JOO
;
Yoo Na KIM
;
Tae Rim SHIN
;
Sang Myeon PARK
;
Dong Gyu KIM
;
Yun Su SIM
Author Information
1. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea. simyunsu@hallym.or.kr
- Publication Type:Case Report
- Keywords:
Tracheoesophageal fistula;
Tracheostomy;
Mechanical ventilation
- MeSH:
Aged;
Dilatation*;
Fatal Outcome;
Female;
Humans;
Respiration, Artificial;
Thorax;
Trachea;
Tracheoesophageal Fistula*;
Tracheostomy*;
Ulcer;
Ventilators, Mechanical*
- From:Korean Journal of Medicine
2014;87(1):87-91
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Patients with tracheostomies requiring prolonged home mechanical ventilation are increasing in number rapidly. A tracheoesophageal fistula is a relatively unusual complication, but this case resulted in a fatal outcome. We describe a tracheoesophageal fistula with tracheal dilation in a 72-year-old female who had a prolonged tracheostomy and nasogastric tube, using a home mechanical ventilator. On enhanced CT images, the tracheostomy tube was well located within the trachea with no abnormal finding. However, chest enhanced CT images obtained 5 months later showed marked circumferential wall thickening of the trachea with tiny ulceration, a markedly increased diameter of the tracheal lumen, and a tracheoesophageal fistula. In patients using home mechanical ventilators, the location and cuff pressure of the tracheostomy tube and the nasogastric tube should be evaluated routinely.
