An anesthetic for the adult patient with congenital tracheoesophageal fistula: a case report.

ABSTRACT

A 20-year-old male with a history of recurrent pneumonia was diagnosed as having an N-type tracheoesophageal fistula. A general anesthetic was planned to facilitate the repair of the tracheoesophageal fistula using a left anterior cervical approach. Intraoperatively, the surgeons were unable to identify the defect after surgical exposure. To facilitate location of the tracheoesophageal fistula, a flexible pediatric fiberoptic bronchoscope was passed through an elbow adapter connected to the endotracheal tube. The scope was then visually passed via the trachea through the defect into the esophagus. The surgeons were able to palpate the fistula with the bronchoscope passed through the defect. Ease of identification allowed the tracheoesophageal fistula to be quickly repaired. At the completion of the surgery, the patient was extubated, and recovery was uneventful. The patient was discharged 48 hours postoperatively.