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KMID : 0882420140870010087
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Korean Journal of Medicine
2014 Volume.87 No. 1 p.87 ~ p.91
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Tracheoesophageal Fistula with Tracheal Dilatation in a Patient with a Tracheostomy Using a Home Mechanical Ventilator
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Kim Byoung-Hoon
Joo Min-Sun
Kim Yoo-Na
Shin Tae-Rim
Park Sang-Myeon
Kim Dong-Gyu
Sim Yun-Su
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Abstract
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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.
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KEYWORD
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Tracheoesophageal fistula, Tracheostomy, Mechanical ventilation
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