Tracheo-Esophageal Fistula: A Case Report

Tracheo-esophageal fistula (TEF) is a rare and complex surgical condition, often resulting from trauma or previous thoracic interventions. We present a case of a 20-year-old male with a history of bamboo injury in 2019, complicated by right lobectomy and pericardial effusion treated with anti-tuberculosis therapy. The patient underwent esophageal fistula closure in February 2023 and feeding jejunostomy in April 2023. He subsequently developed inability to swallow even saliva, necessitating surgical repair of TEF. Anesthetic management was challenging due to the difficult airway and proximity of the fistula to the carina. A flexometallic endotracheal tube (ETT) was placed via fiber-optic bronchoscope, and anesthesia was maintained with oxygen, air, sevoflurane, and atracurium infusion. Postoperatively, the ETT was converted to nasal intubation to facilitate airway hygiene and prevent complications. This case highlights the anesthetic and surgical challenges in TEF repair and underscores the importance of meticulous preoperative planning, intraoperative management, and postoperative care.