Tracheoesophogeal fistula occurs when the trachea
and the esophagus communicate through an adjacent
perforation in each. A hallmark of tracheoesophageal
fistula is the presence of tube feedings within the tracheo -
stomy tube. This type of fistula can be due to overinflation
of the cuff in patients who also have a feeding tube
or to direct trauma during the tracheotomy procedure. Signs and symptoms include copious secretions, dyspnea,
signs and symptoms of aspiration, cuff leak, and
gastric distention.38,43 Tracheoesophageal fistula is diagnosed
on the basis of findings on computed tomography
or barium esophagography. Treatment includes placement
of a double stent in both esophagus and trachea or
surgical repair.