Plastic and Reconstructive Surgery Global Open · 7 authors, 3 centres
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A 9-month-old boy with a large acquired tracheoesophageal fistula after button battery ingestion underwent surgical closure using a pedicled supraclavicular artery island flap. The flap successfully closed the defect, though temporary tracheostomy was required due to flap bulk obstructing the tracheal lumen.
This case report describes a 9-month-old boy who developed an acquired tracheoesophageal fistula (20 mm × 20 mm) following button battery ingestion. The patient presented with pneumonia, stridor, and respiratory distress requiring transfer to a pediatric intensive care unit. Postoperatively, the flap was viable on day 4, but tracheal lumen obstruction by excess flap bulk necessitated tracheostomy at day 22. The patient achieved spontaneous breathing, oral intake by day 27 with logopedic supervision, and was referred to rehabilitation at day 39. This single case demonstrates that SCAIF is feasible for large acquired pediatric tracheoesophageal fistulas, though flap bulk and differential growth rates between flap and surrounding tissue remain challenges requiring longitudinal follow-up.
