TRACHEOESOPHAGEAL FISTULA COMPLICATING PROLONGED TRACHEAL INTUBATION: ABOUT TWO CASES REPORT AND A REVIEW OF THE LITERATURE

Tracheoesophageal fistula (TEF) is a rare but serious complication of prolonged intubation, most commonly resulting from tracheal ischemia secondary to excessive cuff pressure, often exacerbated by the presence of a nasogastric tube.Diagnosis is frequently delayed due to nonspecific clinical manifestations.We report two cases observed in the intensive care unit: a diabetic patient intubated for status epilepticus, and a young man with severe traumatic brain injury. In both situations, TEF was suspected based on signs of aspiration and confirmed by bronchoscopic examination.Initial conservative management was undertaken,consisting of esophageal rest through jejunostomy feeding combined with treatment of pulmonary infections. The outcome was unfavorable in the first patient, who died before corrective surgery, and favorable in the second patient, who is currently awaiting surgical repair.These cases highlight the importance of early diagnosis and the need for a tailored, multidisciplinary management approach.