Modified Endoscopic Vacuum Assisted Closure (E-VAC) is a novel minimally invasive technique for treating esophageal pleural fistulas

•Esophageal dehiscence and pleural fistula as a surgical complications in the pediatric population have clinical, endoscopic, and surgical treatments without demonstrating the superiority of one.•For this reason, expectant management with nothing by mouth, enteral or parenteral nutrition, and chest tube continues to be the first choice.•We propose using an endoscopically assisted negative pressure system as a treatment for esophageal dehiscence or pleural fistula.•The E- VAC presents a modification in its conformation that allows the repositioning of the system and the endoscopic control without the need to be changed, in addition to offering in our study effectiveness in all the patients described.