Tracheoesophageal fistula with complex injury to the existing anomaly - Youngest neonate to survive: A case report | [Journal of Neonatal Surgery • 2021]

Author(s):

1. Selvarajan Namasivayam: Kanchi Kamakoti CHILDS Trust Hospital, 12A Nageswara Road, Nungambakkam, Chennai 600034, India

2. Natarajan Chandra Kumar: Kanchi Kamakoti CHILDS Trust Hospital, 12A Nageswara Road, Nungambakkam, Chennai 600034, India

3. Singaravelu Ramesh: Kanchi Kamakoti CHILDS Trust Hospital, 12A Nageswara Road, Nungambakkam, Chennai 600034, India

4. Vijayakumar Vanathi: Kanchi Kamakoti CHILDS Trust Hospital, 12A Nageswara Road, Nungambakkam, Chennai 600034, India

5. Muthukrishnan Saravana Balaji: Kanchi Kamakoti CHILDS Trust Hospital, 12A Nageswara Road, Nungambakkam, Chennai 600034, India

6. Mokrala Naga Srinivasa Uday Bhaskar: Kanchi Kamakoti CHILDS Trust Hospital, 12A Nageswara Road, Nungambakkam, Chennai 600034, India

7. Akhtarkhavari Anis: Kanchi Kamakoti CHILDS Trust Hospital, 12A Nageswara Road, Nungambakkam, Chennai 600034, India

Abstract:

Background: Complex injury to the esophagus, trachea, and tracheoesophageal fistula in a case of esophageal atresia is rarely reported that requires prompt identification and management. Case Presentation: A very-low-birth-weight preterm with a tracheoesophageal fistula on ventilatory support for respiratory distress syndrome was transferred to our hospital. The baby developed air-leak through the tracheoesophageal fistula into the stomach causing gross distension of the stomach and reduction in oxygen saturation. Repositioning and reintubation failed to reduce the abdominal distension and to improve the saturation. Subsequent intubation with large volume, low pressure cuffed tube, and replacement of Replogle tube resulted in pneumothorax and further deterioration requiring emergency thoracotomy. Complex tracheoesophageal injury to the esophagus, trachea, and fistulous tract was repaired. Conclusion: The baby survived the early repair of the tracheoesophageal fistula and the iatrogenic complex tracheoesophageal injury. Pre-operative tracheo-esophagoscopy with stenting of the fistula with Fogarty catheter helped to carry out a successful repair technically

Page(s): 1-17

DOI: 10.47338/jns.v10.940

Published: Journal: Journal of Neonatal Surgery, Volume: 10, Issue: 1, Year: 2021

Keywords:

Neonate , Esophageal Atresia , preterm , Tracheoesophageal fistula , Tracheoesophageal trauma

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