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Case Report
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Korean J Med. 2014;87(1):87-91. Published online July 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.87.1.87
- 기관절개 상태로 가정에서 인공환기 중에 발생한 기관확장과
기관식도루
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김병훈1, 주민선1, 김유나2, 신태림1, 박상면1, 김동규1, 심윤수1
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1한림대학교 강남성심병원 호흡기 알레르기내과
2한림대학교 강남성심병원 영상의학과
- Tracheoesophageal Fistula with Tracheal Dilatation in a Patient with
a Tracheostomy Using a Home Mechanical Ventilator
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Byounghoon Kim1, Min Sun Joo1, Yoo Na Kim2, Tae Rim Shin1, Sang Myeon Park1, Dong Gyu Kim1, Yun Su Sim1
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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.
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- 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
