title: Complications of surgical closure of tracheo-cutaneous fistula in pediatric patients - two case reports.
abstract: Tracheocutaneous fistula is seen frequently in decannulated children and respiratory complications associated with primary surgical closure can be potentially fatal. Cough is a precipitating factor for an air leak and we report two cases in which this occurred. A tracheotomy was performed on a 5-month-old girl for mechanical ventilation. Decannulation was successful at the first attempt. One year later, she presented with a persistent tracheo-cutaneous fistula. After surgical closure without drainage, she developed subcutaneous emphysema during a coughing episode. Sutures were removed. A 9-month-old boy presented with oxygen-dependence after lung disease and a tracheotomy was performed for respiratory support. Decannulation was successful at the first attempt 6 months later. He developed a pneumomediastinum after surgical closure of a tracheo-cutaneous fistula. Sutures were removed but replacement of a tracheotomy tube was required. In both cases the wounds were allowed to heal by secondary intention.
authors.affiliation: Département d'Anesthésie-Réanimation Chirurgicale II, Hôpital Claude Huriez, CH & U Lille, rue Michel Polonovski, F-59037, Lille, France.
authors.forename: E
authors.initials: E
authors.lastname: Wiel
authors.forename: P
authors.initials: P
authors.lastname: Fayoux
authors.forename: B
authors.initials: B
authors.lastname: Vilette
mesh_terms: D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D016156:Respiratory Tract Fistula / Q000209:etiology / Q000601:surgery*; D013352:Subcutaneous Emphysema / Q000209:etiology* / Q000628:therapy; D014133:Tracheal Diseases / Q000209:etiology / Q000601:surgery*; D014140:Tracheotomy / Q000009:adverse effects