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Tracheoesophageal fistula: A rare complication after tracheostomy in Covid-19
Lung India ; 39(SUPPL 1):S154, 2022.
Article in English | EMBASE | ID: covidwho-1856979
ABSTRACT

Background:

Tracheoesophageal fistula (TEF) is a rare condition that can be congenital or acquired. Patients of COVID-19 remain intubated for prolonged periods that can give rise to a multitude of complications. We came across a case where patient develop TEF after 7 days of tracheostomy. Case Study 34 years female admitted with Covid pneumonia. Patient required ICU care for respiratory distress, required intubation. Patient was treated with standard treatment and kept on controlled ventilation. Patient underwent tracheostomy on day 12 of intubation. On day 17 of patient had an episode of sudden severe respiratory distress, desaturation, hypotension tachycardia not generating tidal volumes and rising peak pressures on ventilator. Patient developed bilateral tension pneumothorax immediately bilateral intercostal drainage tubes insertion done and patient settled. On day 19 patient had persistent cough with RT feeds coming through tracheostomy tube and site. Suspecting TEF CT neck with thorax was done. A rent is seen in the tracheal and esophageal walls close to the bulb of tracheostomy tube. with a TEF. Long tracheostomy tube was inserted as conservative management.

Discussion:

COVID-19 patients with severe pneumonia may require and remain on prolonged mechanical ventilation. The sudden deterioration of respiratory status, gastric distension and food particles in intubated tube are suspicious to TEF.

Conclusion:

Early tracheostomy can prevent some complications of prolonged intubation. If a patient develops sudden desaturation, gastric distension and food particles in tracheostomy tube then TEF should always be in the differential diagnosis.
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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Lung India Year: 2022 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Lung India Year: 2022 Document Type: Article