Posttracheostomy tracheooesophageal fistula – an unusual presentation

• Main Authors: Deepa Chandramohan, Shaila Kamat, Ravindran V
• Format: Article
• Language: English
• Published: Health and Medical Publishing Group 2016-07-01
• Series: Southern African Journal of Critical Care
• Online Access: http://www.sajcc.org.za/index.php/sajcc/article/download/232/255

Tracheostomy, one of the oldest known surgical procedures in the history of medicine, is regularly performed in modern intensive care units.Acquired ulcerative tracheo-oesophageal fistula (TOF) is an uncommon but potentially fatal complication of tracheostomy. We report a case ofulcerative TOF with an unusual yet characteristic presentation, in a ventilator-dependent tracheostomised patient with Guillain-Barré syndrome.It presented as sudden progressive severe abdominal distension that was rhythmic with each ventilator breath. The predisposing factors, clinicalfeatures and preventive measures of post-tracheostomy TOF are discussed in this case report. Regular monitoring of tracheal tube cuff pressuresand volumes, along with avoidance and treatment of various predisposing factors, are advisable for the prevention of this serious consequence.