A rare case of late malignant gastro-tracheal fistula following esophagectomy for cancer

The occurrence of gastro-tracheal fistula after esophagectomy for carcinoma with gastric pull-up is an uncommon and lifethreatening event. A 43 year-old male patient underwent transhiatal esophagectomy for esophageal cancer. Two years following the operation the patient developed dyspnea, cough and respiratory distress with an increase in tracheal secretion. A gastrotracheal fistula was diagnosed with a concomitant pneumo-mediastinum and subcutaneous emphysema. A covered metallic tracheal stent was used to close the fistula. This attempt proved successful, and the patient began eating an oral diet and was discharged on the 3rd postoperative day. The patient died from cachexia 4 months after stent insertion