Notice tracheal agenesis thattracheal intubation in newborns can not be

Abstract

Introduction and aim: Tracheal agenesis is a rare congenital anomaly. Newborn with tracheal agenesis usually present with respiratory distress, cyanosis and aphony. Endotracheal intubation is not possible in patient with tracheal agenesis. Herein we present a newbom with tracheal agenesis which is diagnosed short after the birth due to tracheostomy and esophagoscopy. Case Report: A ma/e infant was bom at 40 weeks ofgestation by vaginal delivery, his weight was 2200 gr. There were no prenatal diagnosis. The baby was intemed at neonatal intensive care unit due to respiratory distress and cyanosis and aphony. After the failure ofthe many attempts with tracheal intubation, consultation ofpediatric surgery was done. Larynx was found obstructed at the !eve/ of cricoid cartilage by laryngoscope and an emergency tracheostomy was peiformed There was no tracheal cartilage in the tracheostomy, expanding esophagus with bag-mask ventilation was created as tracheostomy. Blood saturation and the patient condition improved At chest x-ray both oflungs were found fully expanded No tracheal opening was found at the emergency esophagoscopy. Only 2. 7 mm O degrees telescope was advanced int o fistula from a tiny orifis in anterior wall of the middle esophagus, the carina and 1.5 cm oftrachea were normal appairing. Tracheal agenesis was thought to be Type II Floyd (or E-type tracheal agenesis ofFaro). He was intubated and taken into the surgical intensive care unit. A.fter theprogressio~ ofrespiratory distress, he died at postnatal 1 il hour. Autopsy was refused by the family. Conclusions: Tracheal agenesis should be considered in newbom with presentedpostpartum sudden onset ofrespiratory distress, and cyanosis, and aphony. Despite esophageal intubatian and gastric decompression trachea/ agenesis remains as a deadly disease stili. Long-term survive is not reportedin the literature. With the development of tissue engineering, qfter the production of cartilage tissue and the reconstructive operations suggest long-term survive.