Iatrogenic esophageal and tracheal perforation with tracheoesophageal fistula following emergency intubation.

Iatrogenic tracheoesophageal fistula (TEF) through direct penetration of esophageal and tracheal walls is exceedingly rare. Body tissues sealing around the tube may result in delayed development of respiratory complications and diagnosis. Pneumomediastinum and pneumothorax may be absent. Maintaining the airway through TEF until tracheostomy resulted in a satisfactory outcome.