Anuntaseree Wanaporn, Patrapinyokul Sakda, Suntornlohanakul Somchai, Thongsuksai Paramee
Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yak, Songkla, Thailand.
Pediatr Pulmonol. 2002 Feb;33(2):162-4. doi: 10.1002/ppul.10039.
A case of initial esophageal atresia and tracheoesophageal fistula in a female newborn, later complicated by pneumonia and a second bronchoesophageal fistula, is reported. She was treated surgically by closure of the tracheoesophageal fistula and by end-to-end esophago-esophageal anastomosis. An esophagram at 1 month of age was normal. Three months later she developed severe, persistent right lower lobe pneumonia that required intensive antibiotic therapy and respiratory support. Esophagography was repeated and revealed a second fistula between the right main-stem bronchus and the lower esophagus. The bronchoesophageal fistula was repaired, and a right lower lobectomy was performed. Postoperative recovery was uncomplicated. Histologic examination indicated that the fistula was congenital in origin. To the best of our knowledge, this is the first reported case of a congenital bronchoesophageal fistula coexisting with a tracheoesophageal fistula and esophageal atresia.
本文报告了一例女性新生儿，最初诊断为食管闭锁和气管食管瘘，随后并发肺炎及第二处支气管食管瘘。通过手术闭合气管食管瘘并进行食管端端吻合术对其进行治疗。1个月大时食管造影显示正常。3个月后，她出现严重的、持续性右下叶肺炎，需要强化抗生素治疗和呼吸支持。再次进行食管造影检查，发现右主支气管与下段食管之间存在第二处瘘管。对支气管食管瘘进行了修复，并实施了右下肺叶切除术。术后恢复顺利。组织学检查表明该瘘管为先天性起源。据我们所知，这是首例报道的先天性支气管食管瘘与气管食管瘘及食管闭锁并存的病例。
