Tracheoesophageal fistula and tracheal stenosis in a patient requiring long-term ventilation by tracheostomy: Conservative treatment and six-year follow-up

SummaryThe treatment of tracheal rupture or noncancerous tracheal fistula is a much debated question. The approach can be more complex if another lesion is present and the patient needs mechanical ventilation. This article describes a 67-year-old man admitted to the ICU, because of acute on chronic respiratory failure, and was intubated in emergency room. Several days after tracheostomy the patient presented two lesions (tracheoesophageal fistula and tracheal stenosis) in his trachea and the need of a mechanical ventilator arose. The problem was resolved using an endotracheal tube through the tracheostomy, which bypassed the lesions. After 20 days the tracheoesophageal fistula closed and the endotracheal tube was replaced with a long tracheostomy tube. After six years the patient continues mechanical ventilation by tracheostomy at home.