ENDOSCOPIC TREATMENT OF A TRACHEO-OESOPHAGEAL FISTULA: ABOUT A CASE
M. Rjimati*, M.C. Benjelloun, B. Amara, M. Elbiaze and M. Serraj
ABSTRACT
Tracheo-oesophageal fistula (TOF) is a rare complication of tumors, mainly lung and esophageal cancer. It is defined by a communication between the esophagus and the trachea or the bronchi. Its prognosis is linked to early treatment. Surgical treatment is well described, but remains very risky in this category of cancer patient; on this, endoscopic treatment with prosthesis fitting by rigid bronchoscopy presents the ideal alternative for a palliative and minimally invasive treatment. We report the case of a 52-year-old patient who was diagnosed with esophageal squamous cell carcinoma in 2017. She received radiochemotherapy. The consequences were marked by the installation of a dry cough concomitant with food intake. As part of her follow-up in radiotherapy, she underwent a thoraco-abdomino-pelvic CT scan, which objectified a Tracheo-oesophageal fistula, which is most likely postradiation. As soon as the fistula was discovered, radiotherapy was suspended and the patient was admitted to our training for endoscopic treatment of her fistula. An endo-tracheal prosthesis was placed by rigid bronchoscopy and the consequences were good. Tracheo-oesophageal fistula is a serious complication of esophageal cancer; its diagnosis is confirmed by chest CT scan and supported by bronchial endoscopy. Tracheal endoptothesis placement is recommended to alleviate the complications of the fistula, and to guarantee a better quality of life.
Keywords: Tracheo-oesophageal fistula, esophageal cancer, rigid bronchoscopy, endo-tracheal prosthesis.
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