Elsevier

Journal of Surgical Education

Volume 64, Issue 4, July–August 2007, Pages 237-240
Journal of Surgical Education

Review
Review of Tracheo-Esophageal Fistula Associated with Endotracheal Intubation

https://doi.org/10.1016/j.jsurg.2007.05.004Get rights and content

Tracheo-esophageal fistula (TEF) formation is a rare complication of either endotracheal intubation or tracheostomy. This complication is generally thought to be iatrogenic and occurs in less than 1% of patients. High-volume, low-pressure cuffs have made TEFs an infrequent occurrence; however, it still poses as a potential life-threatening condition. Evaluation and close monitoring of endotracheal tube (ETT) cuff pressures is an area of significance commonly overlooked and/or underemphasized by surgical residents. To illustrate and review this clinical problem, a case of an iatrogenic TEF as a consequence of excessive endotracheal cuff pressures is reported.

Section snippets

Discussion

Several causes exist for esophageal perforation. Besides trauma and malignancy, esophageal perforation usually occurs as a result of iatrogenic injury. Operations in and around the esophagus, endoscopy, and intraluminal procedures are among the most common scenarios in which perforation occurs. Donnelly1 demonstrated that prolonged duration of intubation resulted in laryngeal damage and ulceration.

After as little as 10 hours of intubation, epithelial disruption, basement membrane loss, and/or

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