Tracheoesophageal fistula secondary to chemical trauma: is there a place for planned conservative management?
OBJECTIVE
We present a unique case in which closure of a large tracheoesophageal fistula was achieved with planned conservative management.


METHODS
The literature was reviewed for other documented cases of spontaneous closure of traumatic tracheoesophageal fistula.


RESULTS
Acquired tracheoesophageal fistula may result secondary to a chemical burn from an alkaline disc battery impacted in the oesophagus, particularly when the presentation, and thus diagnosis, are delayed. This condition is rare. The majority of such cases occur in children, and are conventionally managed with surgical repair. We found only three previously reported cases in which conservative management was attempted.


CONCLUSIONS
Non-interventional management should be tried initially for the management of paediatric acquired tracheoesophageal fistula, to permit closure by secondary intention.
Biswas
D
D
Department of Otolaryngology, Sheffield Children's Hospital, University of Sheffield, Sheffield, South Yorkshire, UK. drdbiswas@hotmail.com
Majumdar
S
S
Ray
J
J
Bull
P
P
D002057:Burns, Chemical / Q000150:complications* / Q000628:therapy; D002675:Child, Preschool; D057210:Delayed Diagnosis; D011211:Electric Power Supplies / Q000009:adverse effects; D004945:Esophagoscopy; D004947:Esophagus; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012074:Remission Induction / Q000379:methods; D014138:Tracheoesophageal Fistula / Q000139:chemically induced / Q000628:therapy*; D016896:Treatment Outcome