Post-traumatic esotracheal fistula caused by a knife: A case report

Traumatic esophageal-tracheal fistulas (ETFs) secondary to a stab wound are rare and often underdiagnosed. Chest computed tomography (CT) scan and opacification of the esophageal lumen help in diagnosis. Surgery is required for treatment. We here report the case of a patient who developed an ETF after being stabbed in the back. Admitted six hours after the incident, he complained of mid-thoracic pain. Physical examination revealed a right paravertebral wound with intrathoracic knife blade. Imagery showed the blade traversing the upper mediastinum, right hemopneumothorax, and mediastinal air bubbles. Surgical exploration revealed a small ETF which was repaired by direct suture of the tracheal and oesophageal orifices with a covering flap. Oral feeding was allowed at D14 after a check-up revealed no residual fistula. The postoperative course was uncomplicated. Esophageal-tracheal fistulas are rare and potentially serious. Early diagnosis and surgical management, combined with good nutrition and infection management, help reduce their morbidity and mortality.