A 3-year-old boy with VACTERL syndrome (oesophageal and anorectal atresia), with multiple reconstructive and esophageal surgeries at the ileocutaneous fistulae level (fistula of origin).
Dilations were initiated due to stenosis of the anastomosis, which were suspended due to exit of the guide wire through the abdominal wall and monthly cervicothoracic abscesses.
A year later, due to the failure of the dilations and the persistence of the fistula, it was decided to place a fully covered 18 mm diameter x 6 cm length ELLA stentable.
From the technical point of view, there was a great difficulty for the transition of the fistula due to rotation and coupling of the proximal esophagus (which we found the fistula surgery) and the incision was made using the gastrotraction tension.
During follow-up, he presented a cervical abscess due to distal displacement of the prosthesis, disappearing with antibiotics and repositioning it.
After 8 months, recurrence occurred. Once the patient was restarted, dilations were restarted. Including this in a prospective protocol with the use of mitomycin C, it was decided to place the stent in the second position.
4 months later the child again presented with absolute dysphagia for liquids, without being able to objectify passage of contrast to distal (this complete defect that is pending a new surgical solution).
Prosthesis degradation time was 5 months for the first and 4 months for the second.
