Acquired tracheo-esophageal fistula in a child caused by an unsuspected esophageal foreign body

Acquired tracheo-esophageal fistula (TEF) is very infrequent in the pediatric age group and is usually caused by esophageal foreign body impaction. Bronchoscopy plays an essential role in the diagnostic work-up of this rare complication. Delayed surgical closure with muscle flap interposition is the treatment of choice if spontaneous healing does not occur. The authors present the case of a 5-year-old boy with an acquired TEF caused by a very unusual esophageal foreign body, treated surgically. Management of this rare entity is discussed. (C) 2008 Elsevier Ireland Ltd. All rights reserved.