title: [A six-year-old girl with dyspnea following tracheocutaneous repair].
abstract: 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.
authors.affiliation: Plastikkirurgisk avdeling, Rikshospitalet, 0027 Oslo. kim.tonseth@rikshospitalet.no
authors.forename: Kim Alexander
authors.initials: KA
authors.lastname: Tønseth
authors.forename: Kjetil
authors.initials: K
authors.lastname: Stubberud
authors.forename: Tomm
authors.initials: T
authors.lastname: Bjaerke
authors.forename: Therese Halvorsen
authors.initials: TH
authors.lastname: Bjark
authors.forename: Gunnar
authors.initials: G
authors.lastname: Bentsen
authors.forename: Sidsel
authors.initials: S
authors.lastname: Hetland
authors.forename: Tom
authors.initials: T
authors.lastname: Hoel
mesh_terms: 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