Korean J Med.  2014 Jul;87(1):87-91.

Tracheoesophageal Fistula with Tracheal Dilatation in a Patient with a Tracheostomy Using a Home Mechanical Ventilator

• Kim B
• Joo MS
• Kim YN
• Shin TR
• Park SM
• Kim DG
• Sim YS

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.

Keyword

Tracheoesophageal fistula; Tracheostomy; Mechanical ventilation

MeSH Terms

Aged
Dilatation*
Fatal Outcome
Female
Humans
Respiration, Artificial
Thorax
Trachea
Tracheoesophageal Fistula*
Tracheostomy*
Ulcer
Ventilators, Mechanical*