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Esophageal and tracheal fistula


Fistula esophageal and tracheal (fistula esophago-trachealis) — a pathological anastomosis between a gullet and a trachea by means of which they are reported among themselves. Can be inborn and acquired.

Пищеводно-трахеальный свищ

Esophageal and tracheal fistula

Reasons of esophageal and tracheal fistula:

Inborn fistula esophageal and tracheal arises as anomaly of development and more often accompanies a gullet atresia, fistula esophageal and tracheal isolated forms less often; acquired — result of an injury (a burn, operation, perforation, a gap) or inflammatory process.

Symptoms of esophageal and tracheal fistula:

Symptoms of a disease are defined by the sizes, the direction of the course of fistula, existence or absence in it a valve mechanism. At rather wide fistula fits of coughing are characteristic during meal. Cough can be followed by suffocation, cyanosis, a phlegm vshcheleniye with food pieces. At fistula with a valve mechanism cough during food can be absent. Sometimes patients note a stethalgia, a voice osiplost, a pneumorrhagia and vomiting with blood. Often the pneumonia accepting a chronic current develops.

For confirmation of the diagnosis carry out test at which via the probe installed at distance of 20 cm from edge of cutters enter the liquid painted by methylene blue into a gullet. At fistula the painted liquid comes to respiratory tracts, at cough the phlegm painted methylene blue is allocated.

However results of test can be negative at narrow fistulas. The most informatively X-ray inspection with administration of contrast water-soluble agent in a gullet. Additional information is given by the endoscopic research of a gullet and trachea allowing to find an opening in a wall of a gullet or trachea.

Treatment of esophageal and tracheal fistula:

Make a section of the fistular course with the subsequent sewing up of defects in walls of a trachea and gullet. At the esophageal and tracheal fistulas caused by disintegration of a tumor, operation is limited to a gastrostomy. The same operation is applied to a temporary exception of food through a mouth.

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