Conservative management of tracheoesophageal fistula (TEF) following disc-battery ingestion

Successful conservative management of an acquired tracheoesophageal fistula

Pediatrics International ◽

10.1111/ped.14534 ◽

2021 ◽

Author(s):

Atsushi Harada ◽

Naoki Shimojima ◽

Hirofumi Tomita ◽

Akihiro Shimotakahara ◽

Seiichi Hirobe

Keyword(s):

Conservative Management ◽

Tracheoesophageal Fistula

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Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion

European Journal of Pediatric Surgery Reports ◽

10.1055/s-0040-1705157 ◽

2020 ◽

Vol 08 (01) ◽

pp. e18-e22

Author(s):

Soichi Shibuya ◽

Takahiro Azuma ◽

Geoffrey J. Lane ◽

Manabu Okawada ◽

Atsuyuki Yamataka

Keyword(s):

Conservative Management ◽

Nutritional Support ◽

Tracheoesophageal Fistula ◽

Relevant Literature ◽

Direct Visualization ◽

Oral Antibiotics ◽

Button Battery ◽

Nonsurgical Management ◽

Nasojejunal Tube

AbstractA 16-month-old boy was referred to our hospital for the management of suspected lithium button battery (LBB) ingestion. He had been previously well, but became febrile with a persistent cough resistant to oral antibiotics and dysphagia for 5 days. Radiography identified an LBB lodged in the upper esophagus. The LBB was retrieved under direct visualization with rigid laryngoscopy. He was sedated for 5 days and enteral feeding was commenced through a nasojejunal tube on the next day after procedure. On day 8 after retrieval, endoscopy and fluoroscopy identified a tracheoesophageal fistula (TEF), 6 mm in diameter. Conservative management was conducted with periodic follow-up endoscopies, which showed signs of healing in the esophagus. Following continuous antibiotics and proactive nutritional support, the TEF was found to have closed spontaneously by day 28 after the LBB removal. We present our experience of the successful nonsurgical management of acquired TEF secondary to LBB ingestion and aim to establish a protocol for managing it conservatively by reviewing the relevant literature.

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Tracheoesophageal fistula secondary to chemical trauma: is there a place for planned conservative management?

The Journal of Laryngology & Otology ◽

10.1017/s0022215110001040 ◽

2010 ◽

Vol 124 (10) ◽

pp. 1136-1138 ◽

Cited By ~ 3

Author(s):

D Biswas ◽

S Majumdar ◽

J Ray ◽

P Bull

Keyword(s):

Conservative Management ◽

Tracheoesophageal Fistula ◽

Surgical Repair ◽

Spontaneous Closure ◽

Chemical Burn ◽

Unique Case ◽

Secondary Intention ◽

Interventional Management

AbstractObjective:We present a unique case in which closure of a large tracheoesophageal fistula was achieved with planned conservative management.Method: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.Conclusion:Non-interventional management should be tried initially for the management of paediatric acquired tracheoesophageal fistula, to permit closure by secondary intention.

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