Enterocutaneous fistula mimicking subcutaneous emphysema after stoma closure: a rarity

Enterocutaneous fistulas, abnormal connections between the intestinal tract and the skin, are rare but serious postoperative complications associated with significant morbidity. This case presents a one-year-old male with anorectal malformation who developed subcutaneous emphysema secondary to an enterocutaneous fistula after colostomy closure and concurrent ureteric reimplantation. The fistula was managed with surgical excision and end-to-end bowel anastomosis, leading to full recovery with no recurrence. This report highlights the importance of considering rare differentials like enterocutaneous fistula in cases of subcutaneous emphysema at the wound site. It also underscores the complexity of managing multiple surgical procedures in pediatric patients and the importance of considering staged surgeries when feasible to reduce postoperative complications and improve outcomes. Timely diagnostic measures such as lateral abdominal X-ray played a critical role in early recognition and successful management.