Ýki Taraftan Bakýþ: Trakeoözafegeal Fistül

Eriþkinlerde malign olmayan trakeoözofageal fistüller genellikle entübasyon sonrasý komplikasyonlar nedeniyle ortaya çýkar. Üç ay önce kafa içi kanama sonrasý uzamýþ entübasyon nedeniyle trakeostomi ve beslenme sorunlarý nedeniyle gastrostomi öyküleri olan 80 yaþýnda kadýn hasta tekrarlayan ateþ ve yoðun kývamlý sekresyon artýþý nedeniyle baþvurdu. Bilgisayarlý toraks tomografisinde saptanan þüpheli trakeoözofageal fistül (TÖF) bronkoskopi ve endoskopi ile doðrulandý. Bronkoskopide hem fazla þiþirilmiþ cuff hem de özefagus kasýlmalarýyla açýlýp kapanan TÖF izlendi. Ameliyata uygun bulunmayan hastaya stent yerleþtirilmesi hasta yakýnlarýn tarafýndan kabul edilmedi. Hasta gastrostomi hattýndan jejunostomi kateteri gönderilerek ve reflüyü engellemek için en az 45 derece dik konumda tutulmasý önerileriyle taburcu edildi.

Viewing from both Sides: Tracheoesophageal Fistula

Non-malignant tracheoesophageal fistulas in adults often occur due to complications after intubation. We present an 80-year-old female patient who was consulted because of fever and increased thicky secretions that need frequent. An intracranial hemorrhage 3 months earlier led to her undergoing a tracheostomy and gastrostomy due to the resulting prolonged intubation and nutritional issues. Both bronchoscopy and endoscopy confirmed the presence of a tracheoesophageal fistula (TEF) detected on computed thorax tomography. In bronchoscopy, TEF, which was opened and closed by both over-inflated cuff and esophageal contractions, was observed. She was not a candidate for surgery, and her relatives declined an esophageal stent placement. We managed the case by sending a jejunostomy catheter through the gastrostomy tube and positioning at least 45 degrees to minimize the reflux.