Abstract
An infant with esophageal atresia (EA) had delayed diagnosis of proximal tracheoesophageal fistula (TEF) and severe tracheomalacia. We recommend bronchoscopy via laryngeal mask or rigid bronchoscopy to rule out associated TEF in infants diagnosed with esophageal atresia, as flexible bronchoscopy via endotracheal tube may not provide complete visualization of the trachea. We also describe a novel cervical approach to tracheopexy via neck incision for treatment of associated severe tracheomalacia in this infant.
Highlights
Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare congenital malformations with an incidence in our area (Alberta, Canada) of 0.21/1000 total births (Lowry et al 2012)
We present a case of an infant with apparent isolated esophageal atresia in whom a previously undetected tracheoesophageal fistula was discovered during postoperative esophageal contrast evaluation of the esophageal anastomosis
The presence of a proximal fistula discovered in a case of presumed pure esophageal atresia is well-recognized and is likely higher than reported (Bax et al 2008)
Summary
Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare congenital malformations with an incidence in our area (Alberta, Canada) of 0.21/1000 total births (Lowry et al 2012). Chest radiograph documented right lower lobe atelectasis Despite replacement of his Repogle suction tube, the tachypnea continued. A capillary blood gas measurement showed evidence of hypercarbia (pCO2 54 mm Hg) and he was transferred into the pediatric intensive care unit and stabilized with continuous positive airway pressure His tachypnea improved and he was placed on low flow oxygen by nasal cannulae. At 14 weeks of age, following a two week period of respiratory stability, the infant had thorascopic repair of his esophageal atresia. He was extubated at 48 hours post-operatively. On the fourth post operative day, the infant was stable and on room air His oral feeding skills progressed rapidly, and he had no respiratory symptoms at rest or during feeding. There have been no ongoing chronic or intermittent respiratory symptoms
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
