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Ann Thorac Surg 2004;77:328-329
© 2004 The Society of Thoracic Surgeons

Case report

Closure of an iatrogenic tracheo-esophageal fistula with bronchoscopic gluing in a mechanically ventilated adult patient

Ermanno Scappaticci, MDa, Francesco Ardissone, MDc, Sergio Baldi, MDa, Francesco Coni, MDa, Flavio Revello, MDa, Pier Luigi Filosso, MDb, Enrico Ruffini, MDb*

a Respiratory Diseases, Ospedale San Giovanni Battista, and University of Torino, Torino, Italy
b Thoracic Surgery, Ospedale San Giovanni Battista, and University of Torino, Torino, Italy
c Department of Thoracic Surgery, Ospedale S. Luigi Gonzaga, Orbassano, Italy

Accepted for publication April 29, 2003.

* Address reprint requests to Dr Shiraishi, Division of Pediatrics, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan 602-8566.
e-mail: isao{at}koto.kpu-m.ac.jp

Management of acquired nonmalignant tracheo-esophageal fistula (TEF) in mechanically ventilated patients is controversial. Surgical correction is often contraindicated because the high operative risk and spontaneous closure is unlikely due to the positive pressure ventilation. We present a case of successful closure of an iatrogenic TEF in a mechanically ventilated patient with bronchoscopic application of fibrin glue. The technique may be proposed in high-risk patients as either an alternative to surgery or as a first-line attempt before surgical correction.






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