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Ryan A. Macke, MD, Tyler Foxwell, BS, James D. Luketich, MD, Katie S

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Presentation on theme: "Ryan A. Macke, MD, Tyler Foxwell, BS, James D. Luketich, MD, Katie S"— Presentation transcript:

1 Pharyngeal Perforation and Tracheopharyngeal Fistula Caused by Foreign Body Impaction 
Ryan A. Macke, MD, Tyler Foxwell, BS, James D. Luketich, MD, Katie S. Nason, MD, MPH  The Annals of Thoracic Surgery  Volume 99, Issue 2, Pages e31-e35 (February 2015) DOI: /j.athoracsur Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Esophagram demonstrates an irregular cavity near the esophagus at C5 to C6 with a tracheopharyngeal fistula. The Annals of Thoracic Surgery  , e31-e35DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Computed tomography images show the fistula from the anterior pharynx to the trachea inferior to the cricoid cartilage. (A) Air in the soft tissues of the pharynx (small arrow) just below the cricoid cartilage (large arrow). (B) Moving cephalad, air tracking in the soft tissues (small arrow) and between the cricoid cartilage and trachea (large arrow). (C and D) Serial images moving cephalad with air in the soft tissues (small arrows) and tracking along the trachea (large arrows). (E) Air in cavity (small arrow) near the esophagus (large arrow). (F) Site of perforation into the trachea (small arrow) with no obvious esophageal perforation (large arrow). The Annals of Thoracic Surgery  , e31-e35DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) Front and (B) back of the foreign body found emanating from the site of pharyngeal perforation. The Annals of Thoracic Surgery  , e31-e35DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Endoscopic view of the fistula traversing the pharyngeal perforation through the right pyriform sinus and into the trachea (white arrow indicates endotracheal tube seen through defect). The Annals of Thoracic Surgery  , e31-e35DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 (A) Bronchoscopic view of the tracheopharyngeal fistula just proximal to the first tracheal ring. (B) View of tracheal stent excluding the fistula. The Annals of Thoracic Surgery  , e31-e35DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 Esophagram shows exclusion of the fistula with the tracheal stent. The Annals of Thoracic Surgery  , e31-e35DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

8 Fig 7 Contrast esophagram shows complete healing of the fistula after stent removal. The Annals of Thoracic Surgery  , e31-e35DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

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