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Korean J Med > Volume 87(1); 2014 > Article
The Korean Journal of Medicine 2014;87(1): 87-91.
기관절개 상태로 가정에서 인공환기 중에 발생한 기관확장과 기관식도루
김병훈1, 주민선1, 김유나2, 신태림1, 박상면1, 김동규1, 심윤수1
1한림대학교 강남성심병원 호흡기 알레르기내과
2한림대학교 강남성심병원 영상의학과
Tracheoesophageal Fistula with Tracheal Dilatation in a Patient with a Tracheostomy Using a Home Mechanical Ventilator
Byounghoon Kim1, Min Sun Joo1, Yoo Na Kim2, Tae Rim Shin1, Sang Myeon Park1, Dong Gyu Kim1, Yun Su Sim1
1Division of Pulmonary, Allergy and Critical Care Medicine, Departments of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
2Radiology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
Corresponding Author: Yun Su Sim ,Tel: +82-2-849-9091, Fax: +82-2-846-4669, Email: simyunsu@hallym.or.kr
Received: August 14, 2013;   Revised: October 2, 2013;   Accepted: October 23, 2013.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Patients with tracheostomies requiring prolonged home mechanical ventilation are increasing in number rapidly. A tracheoesophageal fistula is a relatively unusual complication, but this case resulted in a fatal outcome. We describe a tracheoesophageal fistula with tracheal dilation in a 72-year-old female who had a prolonged tracheostomy and nasogastric tube, using a home mechanical ventilator. On enhanced CT images, the tracheostomy tube was well located within the trachea with no abnormal finding. However, chest enhanced CT images obtained 5 months later showed marked circumferential wall thickening of the trachea with tiny ulceration, a markedly increased diameter of the tracheal lumen, and a tracheoesophageal fistula. In patients using home mechanical ventilators, the location and cuff pressure of the tracheostomy tube and the nasogastric tube should be evaluated routinely.
Keywords: Tracheoesophageal fistula; Tracheostomy; Mechanical ventilation
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