A tracheoesophageal fistula closed after being patent for over half a century

Abstract

A 54-year-old man presented with a chief complaint of “a hole in his esophagus.” According to the patient, this had been diagnosed at birth and had never been definitively treated, although he stated that his prior physicians were aware of it. He described a lifetime history of chronic aspiration, which he had learned how to minimize by eating certain foods and swallowing with his neck severely flexed. Still, he had had innumerable episodes of pneumonia requiring treatment. A contrast study showed a large tracheoesophageal (TE) fistula with free extravasation of contrast material into the airway (A).