Tracheo-oesophageal fistula from blunt trauma. A case report

Tracheo-oesophageal fistula is a rare complication of blunt trauma; by 1980 only 35 cases had been recorded. Presentation is usually delayed and the initial trauma severe. Fractures, pneumothorax, haemoptysis and surgical emphysema are not invariable features. Mediastinitis is rare, and surgical management is usually successful. The site of the fistula in the posterior wall of the trachea proximal to the main carina is remarkably constant. The membranous trachea is probably lacerated at the time of injury and the oesophageal wall contused. The contusion progresses to necrosis and a fistula is formed.