Surgical Treatment of a Post Traumatic Œso Tracheal Fistula by Bi-œsophageal Exclusion and Digestive Plasty

Seance of wednesday 12 june 2013 (SEANCE COMMUNE AVEC LA SOCIETE PIEMONTAISE)

Abstract

We report an interesting and rare case of post traumatic œso-tracheal fistula operated by esophageal bi-exclusion and digestive plasty. The post traumatic œso-tracheal fistula is a rare but grave pathology. Syndrome includes: dysphagia, food choking, spilling out food with phlegm, weights lost and other complications in relation with swallowing problems. The diagnosis is often not made at the initial period. Clinical diagnosis: oeso-gastroscopy, bronchoscopy, esophageal opacification transit and chest CT scan, œso-gastroscopy, bronchoscopy, esophageal opacification transit are good methods of examination and diagnose even the size of fistula is small. Death can be caused by lung and other mediastinal complications. Without surgery, the mortality rate is 80%, but it decreases to 9.3% in case of surgery. Treatment by medicines, biological glue, tracheal and oesophageal prosthesis are only temporarily effective. Surgical treatment is the unique effective possibility for post-traumatic œso-tracheal fistula; it depends of the dimension of fistula. In case of large fistula, the bi-exclusion method of œsophagus with digestive replacement by the stomach or the colon is an effective solution, especially in low and developed economy country as Cambodia.