Esotracheal Fistula in Esophageal Stenoses of Malignant Origin - Case Report

Background: Approximately 80% of acquired eso-tracheal ormediastinal fistulae are of malignant nature. The occurrence ofan eso-respiratory malignant fistula is a devastating complication for both patient and doctor, and, if not treated, records a survival time of 1 to 6 weeks. Matherial and method: We present a patient, aged 51, smoker,with progressive dysphagia, at first to solids, then to semi-solidsand liquids, followed by manifestation of post-deglutition coughdue to eso-tracheal fistula, incapability of feeding, and decline of the general condition. Surgical intervention consists of esophageal transstenotic endo-prosthesing by transtumoral drilling with prosthetic montage and the occlusion of the eso-tracheal fistulous orifice. Results: The post-operatory evolution is favorable, the feedingper os resumes in 8 hours after surgery, good digestive tolerance. The radiologic examination using contrast medium, performed in 48 hours after surgery, reveals a permeableesophageal endo-prosthesis, without reflux of contrast substancein the tracheobronchial tree. Conclusions: The laparo-gastroscopic montage of prosthesisthrough transtumoral drilling, using siliconized semi-rigidprostheses, represents the only efficient palliative treatment of malignant eso-tracheal or eso-bronchial fistula.

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