Congenital Esophageal Atresia with Tracheoesophageal Fistula -A Case Report-

선천성 식도폐쇄 및 기관식도루 -1례 보고-

  • Published : 1994.06.01

Abstract

Our patient was a 2.3 kg, male of 33 weeks gestation and spontaneous vaginal delivery. Copious salivary secretion, mild aspiration pneumonia episode due to tracheoesophageal fistula and intermittent cyanotic appearance due to hypoxia were noted shortly after birth. Head up position, frequent upper pouch suction, and adequate fluid and antibiotic therapy were done in incubator. Combined Chest and abdominal film was revealed gas in the stomach and an haziness in right chest with mediastinal shift to the right side. Esophagogram revealed markedly dilated proximal esophagus as blind pouch, and Two dimensional echocardiography showed the Ventricular Septal Defect. The conclusion was congenital esophageal atresia with tracheoesophageal fistula, Vogt-Gross type C, Waterston Risk Category B. Surgical correction with Beardmore anastomosis was performed extrapleurally through 3rd rib bed after the cannulation of umbilical vein and preliminary gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought down to the presenting surface of the lower esophageal segment that incised, and end to side anastomosis was underwent using interrupt suture placed through the full thickness of both upper pouch and lower esophageal segment. The postoperative patient was well tolerated and recovered uneventfully, permitted feeding on 7th postoperative day after esophagogram.

Keywords

References

  1. Prognosis and treatment of congenital atresia of the esophagus Sulamaa,M.;Gripenberg,L.;Ahvenainen,E.K.
  2. New Engl J Med v.240 Esophageal atresia with tracheoesophageal fistula;Epidemiologic and teratologic Implication Ingalls,T.H.;Prindle,R.A.
  3. Pediatrics v.34 Esophageal atresia and tracheoesophageal fistula: A survey of its members by the surgical section ot the American Academy of Pediatrics Holder,T.M.;Could,D.T.;Lewis,J.E.;Pilling,G.P.
  4. 대흉외지 v.20 선천성 식도폐쇄 및 기관식도루 권우석;박형주;최영호;김학제;김형묵
  5. New Engl J Medi v.230 The surgical treatment of esophageal atresia and tracheoesophageal fistula Ladd,W.E.
  6. Surg Gynecol obstet v.76 Congenital atresia of esophagus with tracheoesophageal fistula;Extrapleural ligation of fistula and end to end anastomosis of esophageal segment Haight,C.;Towsley,H.A.
  7. J Pediatr Surg v.13 Esophageal atresia with tracheoesophageal fistula: End to End versus End to Side repair Pietsch,J.B.;Stokes,K.B.;Beardmore,H.E.
  8. J Pediatr Surg v.24 Esophageal Atresia with Distal Tracheoesophageal Fistula: Associated Anomalies and Prognosis in the 1980s Sigmund,H.E.;Barry Shandling;David Wesson;Robert,M.F.