Prolonged Intubation Induced Tracheoesophageal Fistula in Suspected Meningococcal Sepsis with ARDS: A Case Report

  • Ramesh Rana Department of Internal Medicine, Gautam Buddha Community Heart Hospital, Butwal, Nepal
  • Rikesh Sapkota Department of Internal Medicine, Gautam Buddha Community Heart Hospital, Butwal, Nepal
  • Binesh Shakya Department of Anesthesiology, Gautam Buddha Community Heart Hospital, Butwal, Nepal
  • Samir Gautam Department of Cardiology, Gautam Buddha Community Heart Hospital, Butwal, Nepal
Keywords: Case report; endotracheal intubation; mechanical ventilation; tracheoesophageal fistula

Abstract

Tracheoesophageal fistula is an abnormal communication between trachea and esophagus. Benign acquired types are rare with the incidence of less than 1%. Prolonged endotracheal intubation remains the most common cause. We are reporting a 28 years old female patient presented with chief complaint of a cough after each meal intake in the outpatient clinic. She had a recent history of admission in the intensive care unit with prolonged intubation (11 days). Her general physical examination, laboratory examination, and chest x-ray were normal. Esophagogastroscopy was performed and revealed communication between upper esophagus and trachea approximately at 14-17cm embedded in longitudinal mucosal folds of the esophagus. She was referred to the higher center for surgical repair. Though, a rare complication, high suspicion is necessary to accurately diagnose the disease in a patient with the history of prolonged intubation.

Published
2018-12-31
How to Cite
Rana, R., Sapkota, R., Shakya, B., & Gautam, S. (2018). Prolonged Intubation Induced Tracheoesophageal Fistula in Suspected Meningococcal Sepsis with ARDS: A Case Report. Journal of Nepal Medical Association, 56(214), 980-982. https://doi.org/10.31729/jnma.3890
Section
Case Reports