Abstract
A preterm boy of 30 weeks and five days did not breathe spontaneously at birth and despite visualization of the vocal cords, intubation attempts did not succeed, until a tube 2.0 was placed using an Eschmann stylette, mistakenly considered endotracheal. A few hours later, suspicion of tube dislocation arose and renewed intubation attempts failed. The ENT specialist performed a tracheoscopy and found a blind ending of the trachea in the subglottic area. The trachea could not be felt below this area. Retrospectively the ventilation went via the esophagus to the lungs. The clinical presentation, the tracheoscopic and CT-scan findings indicated a tracheal agenesis Floyd type 3. This is a rare congenital and usually lethal malformation. Specific antenatal and clinical findings may indicate and facilitate early diagnosis. We hope that this case presentation will raise the awareness of a tracheal agenesis.
Highlights
Tracheal agenesis (TA) is a rare congenital malformation with an incidence of 1 per 50,000-100,000 newborns and approximately 150 cases reported since its first description by Payne in 1900 [13]
We report the fourth TA patient at our institution with special emphasis on early recognition and awareness for this diagnosis [2]
This case report of the fourth TA patient at our institution demonstrates that clinicians can be confronted with unexpected rare congenital upper airway anomalies [2]
Summary
Tracheal agenesis (TA) is a rare congenital malformation with an incidence of 1 per 50,000-100,000 newborns and approximately 150 cases reported since its first description by Payne in 1900 [13]. A preterm boy of 30 weeks and five days did not breathe spontaneously at birth and despite visualization of the vocal cords, intubation attempts did not succeed, until a tube 2.0 was placed using an Eschmann stylette, mistakenly considered endotracheal. The clinical presentation, the tracheoscopic and CT-scan findings indicated a tracheal agenesis Floyd type 3.
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