P-05: A Case Study of Long Gap Oesophageal Atresia Followed to Adulthood

Abstract

To report a single interesting case study involving the fifteen year follow-up of a child with long gap oesophageal atresia (LGOA) A 30 week gestation baby was transferred in utero from a peripheral hospital due to concerns over prolonged rupture of membranes. The baby was born in good condition by normal delivery and was noted to have increased secretions and a diagnosis of pure oesophageal atresia was made. A Stamm gastrostomy was made on day 2 of life and a Replogle tube was left in situ. After 6 weeks of aggressive feeding to induce reflux the child proceeded to thoracotomy and a tight anastomosis was performed. He was paralysed for 10 days post-operatively and was ventilated for three weeks. Subsequent contrast showed an anastomotic stricture and gastro-oesophageal reflux (GOR). He underwent serial balloon dilatations and at 7 months of age had an open fundoplication. He made an excellent recovery and was followed up routinely. At the age of four he complained of some dysphagia, but there was no evidence of further stricture and was treated medically for GOR. Further contrast studies over the next decade demonstrated a patent anastomosis and at the age of fourteen he underwent oesophageal manometry and impedance studies. These have interestingly shown no obstruction, but no demonstrable peristaltic waves in the oesophagus. The authors discuss the images and long-term outcome and review the current literature.