Management of Tracheal Agenesis with Esophageal Intubation Can Save Lives: A Reminder for Anaesthesiologist and Neonatologist

AuthorEsra Caliskanen
Issued Date2018-08-31en
AbstractIntroduction: Tracheal agenesis (TA) is a rare congenital anomaly presenting at birth with respiratory distress and difficult airway management. Polyhydramnios and premature labor are often pathologies associated with these pregnancies, which makes patient management more difficult. TA is often associated with other organ system anomalies (such as cardiovascular, renal and limb anomalies). Hereby, we report a case of tracheal agenesis who is presenting to our pediatric surgery and anesthesiology clinics. Case Presentation: An 30 weeks’ premature infant was transferred to our neonatal intensive care unit, with the diagnosis of tracheal agenesis. He had failed attempts at intubations because of failing to visualize the vocal cords. It was learned that immediately, his respiratory tract was secured via cervical oesophagostomy using long tracheostomy cannula and the infant was subsequently stabilized by gently ventilated. The diagnosis was confirmed on CT scan. It was performed distal oesophageal banding at the upper gastroesophageal junction with gastrostomy. On postoperative day 12 in intensive care unit, the baby further got complicated with a developing cyanosis and circulatory insufficiency. Cardiorespiratory arrest was developed and the infant died after 40 minutes after resuscitation. Conclusions: Successful approach at tracheal agenesis depends on, either prenatal diagnosis or recognition of this situation immediately after birth. In recent years, long time survival has been reported in tracheal agenesis through various surgical approaches. Therefore, it should be remembered that early esophageal ventilation is a life-saving alternative.en
DOIhttps://doi.org/10.5812/compreped.60388en
KeywordPediatricen
KeywordTracheal Agenesisen
KeywordAnesthetic Managementen
KeywordIntubationen
PublisherBrieflandsen
TitleManagement of Tracheal Agenesis with Esophageal Intubation Can Save Lives: A Reminder for Anaesthesiologist and Neonatologisten
TypeCase Reporten

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