Global Surgery ArticleRecurrent and acquired tracheoesophageal fistulae (TEF)—Minimally invasive management
Section snippets
Patients and methods
- 1.
Nine children, age 3 month to 3 years (mean 1.5 years) were referred to the pediatric surgery Service at The Aga Khan University Hospital, Karachi, Pakistan between 2003 and 2015. After approval from Ethical Review Committee (ERC), medical records were reviewed for patient demographics, symptoms and signs, medical and surgical history, location and size of TEF, management and outcome.
- 2.
Diagnosis of recurrent and acquired TEF was based on the presence of symptoms, contrast study of esophagus using
Results
The results are summarized in Table 1. Nine children (7 male and 2 female) with acquired (n = 6) and recurrent TEF following EA/TEF repair (n = 3) were managed. Acquired TEF developed 1 to 3 weeks after removal of esophageal FB—20 mm lithium battery-Maxell 2032 (3), sharp metallic nail (1) ballpoint pen (1) and accidental acid ingestion (1). Most of the patients presented with a history of choking on feedings and recurring respiratory infections. The site of the fistula was mid trachea (5), distal
Discussion
Recurrent TEF is reported in 3% to 20% of babies following repair of EA and TEF, despite refinements in the surgical technique and improvement in survival [1], [3], [4]. Acquired TEF is a rare entity in children, and is mostly caused by FBI (e.g., button battery), corrosive ingestion, iatrogenic injuries following tracheostomy as well as endotracheal intubation, and is rarely secondary to malignancy [5], [6], [7], [8]. Over the last three decades, ingestions of button batteries have increased
References (29)
- et al.
Endoscopic management of recurrent tracheoesophageal fistula
J Pediatr Surg
(2008) - et al.
Endoscopic management of recurrent congenital tracheoesophageal fistula: a review of techniques and results
Int J Pediatr Otorhinolaryngol
(2007) - et al.
Management of acquired tracheoesophageal fistula with various clinical presentations
J Pediatr Surg
(2011) - et al.
Acquired tracheo-esophageal fistula in the pediatric population
Int J Pediatr Otorhinolaryngol
(1998) - et al.
Management of tracheoesophageal fistula as a complication of esophageal dilatations in caustic esophageal burns
J Pediatr Surg
(1995) - et al.
Severe injuries from coin cell battery ingestions: 2 case reports
J Pediatr Surg
(2009) - et al.
Acquired tracheo-esophageal fistula in a child caused by an unsuspected esophageal foreign body
Int J Pediatr Otorhinolaryngol Extra
(2008) - et al.
Primary repair of tracheoesophageal fistula secondary to disc battery ingestion: a case report
J Pediatr Surg
(2004) - et al.
Button battery ingestion in children
Gastrointest Endosc Clin N Am
(2016) - et al.
Button battery ingestion: hazards of esophageal impaction
J Pediatr Surg
(1999)