• Tidsskr. Nor. Laegeforen. · May 2005

    Case Reports

    [A six-year-old girl with dyspnea following tracheocutaneous repair].

    • Kim Alexander Tønseth, Kjetil Stubberud, Tomm Bjaerke, Therese Halvorsen Bjark, Gunnar Bentsen, Sidsel Hetland, and Tom Hoel.
    • Plastikkirurgisk avdeling, Rikshospitalet, 0027 Oslo. kim.tonseth@rikshospitalet.no
    • Tidsskr. Nor. Laegeforen. 2005 May 4; 125 (9): 1184-6.

    BackgroundA 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.Material And MethodsThe 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.InterpretationOperative 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.

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