Posttraumatic Tracheal Ballooning and Tracheoesophageal Window in a 16-Year-Old Girl.

Background: Tracheoesophageal injury following blunt cervical trauma is a rarely described condition, especially in young patients.

Methods: Imaging documentation and clinical management of a tracheoesophageal fistula (TEF) associated with significant enlargement of the tracheal lumen occurring in a 16-year-old girl after a road accident was reported.

Results: Due to impaired neurological status, the girl was intubated and underwent a 2-week course of invasive mechanical ventilation. When weaning attempts were made, air leak and tracheal enlargement were noticed, consistent with a wide TEF. Surgical tracheostomy and feeding jejunostomy were performed to promote fistula healing and serial endoscopic evaluations were performed. After 3 months, surgical repair by a vascularized muscular flap allowed to establish esophageal and tracheal continuity, leading to a complete functional recovery.

Conclusions: Posttraumatic TEF is a rare condition in adolescence and it requires a multi-disciplinary approach for diagnosis and treatment. In this case, a multi-step approach was adopted, eventually achieving a complete resolution.