# Tracheoesophageal Fistulas Unrelated to Malignancy: A Case Series

## TL;DR

This paper presents nine cases of tracheoesophageal fistulas unrelated to cancer, emphasizing the challenges in diagnosis and the use of palliative care due to high mortality.

## Contribution

The study provides a case series highlighting the management challenges and palliative focus in non-malignant tracheoesophageal fistulas.

## Key findings

- Tracheoesophageal fistulas are often diagnosed late and have high mortality.
- Palliative treatment is commonly used due to comorbidities and ventilator dependency.
- Surgical intervention is rarely feasible, so interventional therapy is emphasized.

## Abstract

Tracheoesophageal fistula (TEF) is a rare, pathological connection between the trachea and esophagus that can be acquired or congenital. Acquired TEF typically occurs due to iatrogenic injuries. There is often a delay in diagnosis due to the rare nature of this condition. These patients have a very high mortality rate, and a multidisciplinary strategy is required for the management of TEF involving specialists from interventional pulmonology, gastroenterology, and thoracic surgery. The clinical features, diagnosis, and management of nine patients with TEF are covered in this article. Eight patients were diagnosed with acquired TEF and one with a recurrence of congenital TEF. Our experience shows that, when patients develop TEF, it is usually a terminal event, and major procedures cannot be tolerated due to multiple comorbidities and ventilator dependency. Thus, these patients are managed with palliative treatment to improve their quality of life. Although surgical intervention is the gold standard for patients with acquired TEF, it is considered feasible in very few cases, so this article focuses primarily on interventional therapy rather than surgery.