Post-intubation Tracheoesophageal Fistula Following Meningioma Excision: A Case Report and Literature Review

A tracheoesophageal fistula (TEF) is defined as a pathological connection between the trachea and the esophagus, leading to a spillover of oral and gastric secretions into the respiratory tract. TEF is either congenital or acquired. Congenital TEFs are rare in adults and are mainly associated with esophageal atresia that presents during infancy and childhood. However, much less is known about acquired TEF, which mainly affects the adult population. In adult patients, the majority of TEFs are acquired, with mediastinal malignancies, such as esophageal cancer and lung cancer, representing the etiology in over half the cases. The principal non-malignant causes of acquired TEFs include post-intubation trauma, chronic infections (e.g., tuberculosis), radiation injury, and post-surgical complications. Because they are rarely encountered in adults, TEFs are often difficult to diagnose and can present with nonspecific signs and symptoms. Endoscopic and surgical measures can be undertaken to prevent life-threatening complications and malnutrition. In this article, we report the case of a 68-year-old female patient who developed a large TEF after prolonged intubation in the ICU post undergoing a craniotomy for meningioma excision.