A 25 weeks gestational age, 755 g neonate with esophageal atresia and tracheoesophageal fistula presents with ileal perforation and esophageal pouch perforation (original) (raw)
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Journal of pediatric surgery, 2015
In extremely low birth weight (ELBW) infants, i.e. <1000g, with esophageal atresia (EA) and tracheoesophageal fistula (TEF), surgical treatment is a real challenge. High morbidity is associated with primary repair of EA on these patients. We report our recent experience with three cases of ELBW infants with EA and TEF treated by lower esophageal banding (LEB). From September 2012 to January 2013, three ELBW infants with EA/TEF were born prematurely with severe respiratory distress. One of them had VACTER association with anorectal malformation (ARM). The gestational age was between 25 and 27weeks, and the mean birth weight was 690g (500-790). All were treated by LEB and gastrostomy, followed by delayed primary thoracoscopy reconstruction. One baby died in the postoperative period because of intraventricular hemorrhage at 7days after initial surgery. Among the 2 others cases, one of them required ligation without section of the TEF with removal of LEB by thoracoscopy at 30days old...
Gastric Perforation in a Neonate with Trachea-esophageal Fistula
Journal of Research in Medical and Dental Science, 2019
The purpose of this study was to present a case with the gastric perforation and pneumoperitoneum due to the mechanic ventilation in a female neonate with congenital esophageal atresia and distal trachea-esophageal. The subject of the present study was one female late preterm neonate with very low birth weight (1.48 Kg). She needed mechanical ventilation because her low oxygen saturation. Gastric perforation and pneumoperitoneum occurred secondary to mechanic ventilation. She had an abdominal paracentesis and an emergency laparotomy. The gastric perforation was repaired, banding of the fistula was applied and gastrotomy tube was inserted. She was stabilized post-operatively but unfortunately died a week after from sepsis and heart failure.
Babies with esophageal and duodenal atresia: a 30-year review of a multifaceted problem
Journal of Pediatric Surgery, 2006
The purpose of this study was to review newborns with esophageal atresia (EA) with and without distal tracheoesophageal fistula (TEF) combined with duodenal atresia (DA) or duodenal stenosis (DS) (web, windsock, diaphragm) to determine which clinical features and treatments give the best results. Methods: Twenty-four newborns were reviewed from 1971 to 2000 inclusive. Seven had EA and 17 had EA with TEF; 15 had DA and 9 had DS. One died after receiving only a gastrostomy. Seven underwent repair of both defects in 1 stage, whereas 16 were repaired separately. Results: Eighteen of 24 (75%) survived. The EA or EA with TEF was repaired first in 5, but the DA or DS was initially overlooked in 4 and 2 died. The DA or DS was repaired first in 11, and all survived. Of the 7 in whom both repairs were done at same setting, 4 survived. Of 6 nonsurvivors, 5 were repaired. Mortality from EA was greater than EA with TEF, and DA was greater than DS. Associated anomalies in 18 (75%) of 24 did not affect survival. Conclusions: Staged repair (ideally within 1 week) is a safe suitable method of management. In EA, the coexistence of DA or DS must be considered because delay in diagnosis may adversely affect outcome. Mortality is a multifactorial phenomenon.
Purpose: This study was performed to evaluate the management of tracheoesophageal fistula (TEF) ± esophageal atresia (EA) under the guidance of preoperative tracheo-bronchoscopy (TrSc). Methods: Between 2007 and July 2014, a total of 26 consecutive newborns who underwent rigid TrSc for suspected TEF were identified. All associated charts and operation reports were retrospectively analyzed. Results: Distal TEF with EA (Gross C) predominated (n = 18). Furthermore, we managed 2 infants with proximal and distal TEF (Gross D) and 4 infants with isolated TEF (Gross E). In our hands, TrSc was feasible in infants with a birth weight above 1300 g. Twenty-five fistulas were identified by endoscopy in 23 patients. In one infant with a birth weight below 1000 g, an attempt to perform TrSc was interrupted, and urgent TEF closure was required. Fistula site at the carina was associated with a high rate of esophageal anastomosis under tension. During surgery, proximal TEF and isolated TEF were safely approached via right cervicotomy (n =5). Conclusion: This study supports the routine use of rigid TrSc at the time of surgery. Rigid TrSc allowed the surgical team to identify the number and location of TEFs, and the incidence of side effects was low.
Congenital Esophageal Atresia with Tracheoesophageal Fistula in a Day Old Neonate: A Case Report
Caliphate Medical Journal, 2021
Congenital esophageal atresia and tracheoesophageal fistula is a rare congenital anomaly that occurs in one per 3000 live births and consist of esophageal discontinuity with or without connection to the trachea. Approximately 92% of patients with esophageal atresia have a tracheoesophageal fistula, which is a congenital fistulous connection between the esophagus and the trachea or a main bronchus. This patient presented with episodes of choking and cyanosis after every feed, respiratory difficulty and a distended abdomen. The plain radiograph of the chest including the abdomen was done where the stomach appeared to be markedly distended with air. The contrast meal performed showed a blind ended esophagus with a coiled feeding tube and pool of contrast in the blind ended esophagus. We present the radiologic findings of this case due to its rare nature and peculiar features.
Pediatric Surgery International, 2005
Temporary transgastric fistula occlusion as salvage procedure in neonates with esophageal atresia with wide distal fistula and moderate to severe pneumonia Abstract A method to achieve distal fistula occlusion by inflating the balloon of a catheter placed at the gastroesophageal junction via a transgastric route was tried in seven consecutive neonates with esophageal atresia and wide distal fistula. Due to associated moderate or severe pneumonia, these infants were at poor anesthetic risk for the definitive repair. The procedure was done under local anesthesia with mild sedation and took an average of half an hour for completion. Another feeding tube was negotiated through another gastrotomy across the pylorus to allow early enteral feeds. Temporary transgastric fistula occlusion (TTFO) allowed better ventilation of the hypocompliant lungs (by increasing resistance at the fistulous end), prevented lung injury due to aspiration of the refluxing gastric juices, and facilitated optimal ventilation by preventing epigastric distension. All study subjects survived this procedure except for one of our earlier study subjects who died of massive pneumothorax that was a procedure-related complication. None of the remaining subjects required mechanical ventilation either after TTFO or after the definitive esophageal repair that was carried out 5-7 days subsequent to TTFO, except for one other neonate with right lung aplasia who began deteriorating 48 h after thoracotomy and died of cardiac failure. There were no anastomosis-related problems among the survivors over a 12-month follow-up. The gratifying results of our study prompt us to suggest that this procedure deserves attention, and its role should be explored for salvaging neonates with type C esophageal atresia with wide fistula and pneumonia in developing countries with few neonatal intensive care services.
Journal of pediatric surgery, 2007
The aim of the study was to assess the outcome after esophageal replacement using gastric pull-up performed in critically ill neonates with esophageal atresia (EA) and tracheoesophageal fistula. During 1998 to 2005, gastric transposition was performed in 27 neonates (mean birth weight, 2.32 kg [1.86-3.0 kg]; mean age, 6.08 days) for post-EA and tracheoesophageal fistula leaks in 17, long gap in 6, and pure EA in 4, using transhiatal route in all. Pyloromyotomy as the drainage procedure was added for all 27 neonates. Patients were followed up at 3, 6, and 12 months for clinical evaluation, gastric clearance, duodenogastric reflux, and gastric pressure profile. Six neonates had ongoing serious chest infection, 3 had lung collapse, and 2 had associated congenital heart disease. Postoperative elective ventilation was provided to all neonates for 2 to 40 days (mean, 10.6 days). Nine neonates developed postoperative leaks in the neck; all healed spontaneously before discharge. Mean hospit...
The Israel Medical Association journal : IMAJ, 2018
The estimated incidence of esophageal atresia (EA) with or without tracheo-esophageal fistula (TEF) is 1:3500 live births. During childhood these patients have various co-morbidities, but the overall quality of life among adults is similar to that of the general population. To evaluate short- and long-term co-morbidities and quality of life among infants born with EA ± TEF at a large single medical center. Medical records of 65 children born over a 21 year period were reviewed for short- and long-term medical data. Telephone interviews were conducted with 46 of their parents regarding medical problems and quality of life after home discharge. The main long-term co-morbidities during the first 2 years of life, 4-6 years of age, and during adolescence (12-16 years) included gastro-esophageal reflux disease (GERD) in 56.5%, 35.8%, and 18.7%, respectively; stridor in 84.8%, 45.2%, and 12.5%, respectively; hyper-reactive airway disease (HRAD) in 43.5%, 35.5%, and 36.5%, respectively; rec...