Barrett’s esophagitis related bronchoesophageal fistula - the diagnostic value of persistent air leak in the ventilated setting

A case of acquired tracheoesophageal fistula (TEF) is presented in a 44-year-old female who presented with acute respiratory failure due to bilateral aspiration pneumonia. The patient had persistent air leak while on mechanical ventilation and underwent bronchoscopy which revealed the above etiology. Histopathology showed Barrett's esophagitis. The patient underwent primary closure followed by a short course of proton pump inhibitors. There are only two prior reported cases of acquired TEF associated with Barrett's esophagitis. This condition should be taken under consideration when investigating of an explained persistent air leak in a mechanically ventilated patient.