Menso Julia E, Reijntjes Maud A, Mussies Carlijn M, van Wijk Michiel P, Zwaveling Sander
Department of Pediatric Surgery, Amsterdam UMC Location AMC, Amsterdam, North Holland, The Netherlands.
Department of Gastroenterology, Amsterdam UMC Location AMC, Amsterdam, North Holland, The Netherlands.
European J Pediatr Surg Rep. 2024 Jan 22;12(1):e20-e22. doi: 10.1055/a-2227-6252. eCollection 2024 Jan.
We present the case of a patient with gross type C esophageal atresia in a preterm neonate (gestational age of 31 weeks + 1 day) with a birth weight of 1,470 g. The fistula was released via a thoracotomy, but no primary anastomosis could be made, due to an unexpected long gap. The distal esophagus was closed and approximated to the blind pouch using traction sutures until an adjacent position was reached. A gastrostomy was created for enteral feeding. Although a second attempt to make an anastomosis was unsuccessful, the patient unexpectedly developed a suture fistula 6 weeks after the first procedure, enabling feeding via a nasogastric tube. Over time, six dilations were necessary. Full enteral feeding was achieved at the age of 6 months. Our case confirms sparse reports that deliberately creating a suture fistula may be a solution in esophageal atresia patients when an unexpected long gap prohibits a primary anastomosis.
我们报告了一例早产新生儿（胎龄31周+1天，出生体重1470g）患有C型食管闭锁的病例。通过开胸手术松开瘘管，但由于出现意外的长间隙，无法进行一期吻合。远端食管关闭，使用牵引缝线将其与盲袋拉近，直至到达相邻位置。行胃造瘘术用于肠内喂养。尽管第二次吻合尝试未成功，但患者在第一次手术后6周意外出现缝线瘘，从而能够通过鼻胃管喂养。随着时间推移，需要进行六次扩张。患儿在6个月大时实现了完全肠内喂养。我们的病例证实了少数报道，即当意外的长间隙妨碍一期吻合时，故意制造缝线瘘可能是食管闭锁患者的一种解决办法。
