[A six-year-old girl with dyspnea following tracheocutaneous repair].
BACKGROUND
A few patients develop prominent scars combined with persistent fistula after the removal of a long-standing tracheostomy tube. The procedure needed to correct the condition is generally considered minor surgery, normally without any significant complications. We describe, however, a patient who developed a particularly complicated postoperative course.


METHODS
The patient was a six-year-old girl who underwent surgery because of significant scar formation and a persistent small tracheocutaneous fistula eight months after removal of the tube. Postoperatively she had a cough attack and developed spontaneously subcutaneous emphysema, pneumomediastinum and bilateral pneumothorax. She required intensive care, thoracic drainage and antibiotic prophylaxis. Over the next days her situation improved and she was discharged on the sixth day.


CONCLUSIONS
Operative treatment of scarring after tracheostomy in which the surgeon also confronts a tracheocutaneous fistula or an opening into the tracheal lumen requires postoperative observation so that any severe complications can be managed.
Tønseth
Kim Alexander
KA
Plastikkirurgisk avdeling, Rikshospitalet, 0027 Oslo. kim.tonseth@rikshospitalet.no
Stubberud
Kjetil
K
Bjaerke
Tomm
T
Bjark
Therese Halvorsen
TH
Bentsen
Gunnar
G
Hetland
Sidsel
S
Hoel
Tom
T
D002648:Child; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011859:Radiography; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D013518:Surgery, Plastic; D014133:Tracheal Diseases / Q000209:etiology / Q000601:surgery*; D014139:Tracheostomy / Q000009:adverse effects