Congenital Tracheoesophageal Fistula Presenting in an Asymptomatic Adult- A Case Report

Y. Devabalan
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Abstract

Introduction: Congenital tracheoseophageal fistula (TEF) involve an abnormal pathological connection between the oesophagus and trachea. Congenital TEF presenting in adults is extremely rare and literature is limited to case series of significantly symptomatic patients. Case presentation: An asymptomatic 41 year-old gentleman presented to clinic, having been diagnosed with a congenital tracheoesophageal fistula 10 years ago on a routine oesophagogastroduodenoscopy (OGD) in Brazil. He underwent a barium contrast swallow revealing contrast in the left main bronchi and significant pooling in the upper trachea. A computerised tomography (CT) scan of the neck and thorax with contrast revealed a small fistula measuring 6mm in diameter between the trachea and the oesophagus at the level of the second thoracic vertebral body. A microlaryngobronchoscopy and examination under anaesthesia visualised a fistula measuring 1.8cm to 2cm superior to inferiorly and similar in transverse dimension, 6-7cm below the level of the glottis. Management and outcome: He opted to have surgical treatment to prevent symptoms developing in the future. A trans-cervical approach was performed, and the oesophageal defect and tracheal defect underwent primary closure with sutures. The oesophageal defect repair was oversewn with the sternohyoid. He recovered well post-operatively but due to the considerable rotation and retraction of the trachea, he suffered a vocal cord palsy. This is improving at the latest follow-up. Discussion: Otolaryngologist (ENT) surgeons need to be aware of asymptomatic adult patients presenting with congenital tracheoesophageal fistulas and the investigation and management options available.
无症状成人先天性气管食管瘘1例报告
简介:先天性气管-食管瘘(TEF)是指食道与气管之间的一种异常病理连接。成人先天性TEF极为罕见,文献也仅限于有明显症状的患者。病例介绍:一位无症状的41岁男士,10年前在巴西进行常规食管胃十二指肠镜检查(OGD)时被诊断为先天性气管食管瘘。他接受了钡餐造影,发现左主支气管有显影剂,上气管有明显淤积。颈部和胸部的计算机断层扫描(CT)显示,在第二胸椎体的水平,气管和食道之间有一个直径为6mm的小瘘管。显微喉支气管镜检查和麻醉下检查可见一个瘘,直径为上下1.8cm至2cm,横向尺寸相似,位于声门水平以下6-7cm。治疗和结果:他选择手术治疗,以防止症状在未来发展。经颈入路,食管缺损和气管缺损用缝合线进行初步缝合。食管缺损的修复由胸骨舌骨覆盖。他术后恢复良好,但由于气管的旋转和收缩,他遭受了声带麻痹。在最近的随访中,情况有所改善。讨论:耳鼻喉科(ENT)外科医生需要意识到无症状的成人患者表现为先天性气管食管瘘和调查和管理的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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