Acquired tracheoesophageal fistula following disc-battery ingestion: Can we watch and wait?

Jedidiah J. Grisel, Gresham T. Richter*, Keith A. Casper, Dana M. Thompson

*Corresponding author for this work

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Acquired tracheoesophageal fistulas (TEF) are rare but dangerous complications of disc-battery ingestion. Management approaches include endoscopic or open surgical repair. Unfortunately, these procedures can be complicated by high rates of recurrent laryngeal nerve injury, tracheal stenosis, recurrent fistula and significant patient mortality. Thus, several authors have advocated the use of esophageal rest as conservative management of acquired TEF to permit closure by secondary intention. This study describes a patient with spontaneous closure of an acquired TEF following disc-battery ingestion. The late recurrence of the TEF following conservative management, and endoscopic and radiographic evidence of closure, illustrates the importance of long term evaluation before assuming fistula resolution. Practitioners must carefully weigh the risks and benefits before deciding surgical versus conservative management of TEF. An extended follow-up of at least 6 months should be instituted with a high index of suspicion if conservative management is utilized. Transtracheal repair using an imbricated suture technique is a good surgical option when conservative management fails.

Original languageEnglish (US)
Pages (from-to)699-706
Number of pages8
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume72
Issue number5
DOIs
StatePublished - May 1 2008

Keywords

  • Acquired
  • Battery
  • Closure
  • Esophagus
  • Repair
  • Spontaneous closure
  • Technique
  • Tracheoesophageal fistula
  • Transtracheal

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine
  • Surgery

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