T tube intubation in the management of seriously ill patients with oesophagopleural fistulae.

Abstract

Ten patients referred late with oesophagopleural fistulae were managed by T tube intubation of the oesophageal defect. Seven survived and six had radiographic evidence of closure of the defect. One patient who removed his T tube early was discharged to convalesce with a small oesophagocutaneous fistula. Three patients died as a consequence of pre-existing renal failure, upper gastrointestinal haemorrhage and adult respiratory distress syndrome. Patients presenting late with multisystem complications and ongoing sepsis secondary to oesophagopleural fistulae pose a major management problem. Our preliminary results suggest that T tube intubation offers a potential alternative to major surgical intervention, when more conservative measures have failed.