Traumatic subarachnoid pleural fistula in children: Case report, algorithm and classification proposal

Abstract

Subarachnoid pleural fistulas are rare. They have been described as complications of thoracic surgery, penetrating injuries and spinal surgery, among others. We present the case of a 3-year-old female child, who suffer spinal cord trauma secondary to a car accident, developing a posterior subarachnoid pleural fistula. To our knowledge this is the first reported case of a pediatric patient with subarachnoid pleural fistula resulting from closed trauma, requiring intensive multimodal management. We also present a management algorithm and a proposed classification. The diagnosis of this pathology is difficult when not associated with neurological deficit. A high degree of suspicion, multidisciplinary management and timely surgical intervention allow optimal management.