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Published on: March 15, 2024
Posttraumatic Tracheal Ballooning and Tracheoesophageal Window in a 16-Year-Old Girl
Marco Piastra1,2, Elisa Meacci3, Jacopo Galli2,4
1Pediatric Intensive Care Unit and Pediatric Trauma Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Background:
Tracheoesophageal injury following blunt cervical trauma is a rarely described condition, especially in young patients.
Methods:
Imaging documentation and clinical management of a tracheoesophageal fistula (TEF) associated with significant enlargement of the tracheal lumen occurring in a 16-year-old girl after a road accident was reported.
Results:
Due to impaired neurological status, the girl was intubated and underwent a 2-week course of invasive mechanical ventilation. When weaning attempts were made, air leak and tracheal enlargement were noticed, consistent with a wide TEF. Surgical tracheostomy and feeding jejunostomy were performed to promote fistula healing and serial endoscopic evaluations were performed. After 3 months, surgical repair by a vascularized muscular flap allowed to establish esophageal and tracheal continuity, leading to a complete functional recovery.
Conclusions:
Posttraumatic TEF is a rare condition in adolescence and it requires a multi-disciplinary approach for diagnosis and treatment. In this case, a multi-step approach was adopted, eventually achieving a complete resolution.
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