Esophageal neoplasm is the seventh cause of death from cancer in the world.1 Malignant tracheoesophageal or bronchoesophageal or, less commonly, esophageal-lung parenchyma fistulas are late developments of advanced cancer of the esophagus, lung or mediastinum.2 The occurrence of an esophago-respiratory malignant fistula is a devastating complication.1 The presence of a respiratory prothesis increases the risk. Its displacement can lead to several complications including total airwaiy obstruction. There are multiple anaesthetic problems presented by patients with respiratory fistulas.3 We describe the anaesthetic management of a 56 year old male patient with a metastatic esophageal cancer diagnosed with a malignant broncho-esophageal fistula and a tracheal prothesis proposed to emergent laparotomy. The anaesthetic management of a patient with an esophago-respiratory malignant fistula is a serious challenge. Our patient had a tracheal prothesis that also raised life-threatening problems during his anaesthetic management. Multipe cares in the perioeprative period were mandatory.

Journal of the Portuguese Society of Anesthesiology, vol. 27 n.º 4 (2018): Revista da Sociedade Portuguesa de Anestesiologia