A fistula can result from thermal injury, acid reflux, infection from the lumen, and ischemic injury caused by thermal occlusion of the end arterioles. Symptoms appear two to four weeks after the procedure and include fever, chills, or recurrent neurologic events. Esophageal fistula can result in septic shock and death. The nurse prepares the patient for CT or MRI scanning of the esophagus, while maintaining the patient's “nothing by mouth” status. The nurse educates the patient on the warning signs and instructs the patient to contact the provider should symptoms develop. An urgent surgical intervention is required to repair a fistula.