Simultaneous correction of esophageal lung and congenital tracheal stenosis: Lessons learned

Abstract

Esophageal lung is a rare variant of communicating bronchopulmonary foregut malformation (CBPFM) that can be associated with congenital tracheal stenosis (CTS). Ten cases have been reported so far. Treatment options include complete pulmonary resection versus detachment and reinsertion into the trachea. If CTS is severe, additional tracheal reconstruction via slide tracheoplasty may become necessary. Here we present jet another child with such a rare variant of CBPFM. The right main bronchus originated from an otherwise healthy esophagus and was associated with long segment congenital tracheal stenosis. The child underwent one-stage reinsertion of the bronchus at the level of the carina and simultaneous slide tracheoplasty at 3 months of age. Unfortunately, the child died from a bronchopleural fistula with massive air leak during the postoperative course. To our best knowledge, this was the first time a one-stage approach was intended for this particular malformation. Because recently the successful correction of a similar malformation was described using a multiple-step approach, by reflecting our own unsuccessful case we critically discuss the management possibilities for this extremely rare variant of foregut malformations.