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CRITICAL CARE AND TRAUMA

Sealing of a Tracheoesophageal Fistula Using a Sengstaken-Blakemore Tube for Mechanical Ventilation During General Anesthesia

Junya Nakada, MD, PhD^*, Sayo Nagai, MD, Masao Nishira, MD^*, Renko Hosoda, MD, PhD^*, Tatsuya Matsura, MD, PhD, and Yoshimi Inagaki, MD, PhD

From the *Department of Anesthesiology, Aichi Cancer Center Hospital, Nagoya, Japan; and Department of Anesthesiology and Critical Care Medicine, Division of Medical Biochemistry, Tottori University Faculty of Medicine, Yonago, Japan.

Address correspondence and reprint requests to Junya Nakada, MD, PhD, Department of Anesthesiology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya 464-8681, Japan. Address email to jn{at}aichi-cc.jp.

A 78-yr-old man was admitted to our hospital because of repeated episodes of pneumonia. Both fiberoptic bronchoscopy and esophagoscopy revealed a large tracheoesophageal fistula and protrusion of the metal stent from the esophagus into the trachea. Placement of a Dumon stent was planned for sealing this fistula under general anesthesia. Anesthetic management is difficult because of the care needed to prevent aspiration of esophageal contents and diversion of oxygen through the fistula into the stomach from the trachea when patients are under mechanical ventilation. Our method of sealing a large tracheoesophageal fistula with a Sengstaken-Blakemore tube was performed successfully.