Tracheoesophageal Fistula with Severe Mediastinitis Following Blunt Chest Trauma

Abstract Tracheoesophageal fistula (TEF) following nonpenetrating injury is a very rare traumatic condition but serious complication that needs an immediate surgical intervention after making an accurate diagnosis. A case of TEF with severe mediastinitis that is rarely accompanied with TEF is reported. An 18-year-old man who had a traffic accident was admitted to the intensive care unit. After 2 days following admission and intubation, bile juice was suctioned from the trachea. TEF was suspected and promptly confirmed by contrast esophagogram. The patient was taken to surgery and underwent a right posterolateral thoracotomy. The tracheal defect was repaired by primary suture with reinforcement of the pedicled intercostal muscle flap and esophageal exclusion and diversion with drainage was performed because of severe mediastinitis. A second-stage esophageal reconstruction with a right colon conduit was performed when he was completely stabilized in the aspects of infection, nutrition and respiration. His postoperative course was uneventful.