Thawkar Varun N, Taksande Karuna
Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Cureus. 2023 Dec 30;15(12):e51359. doi: 10.7759/cureus.51359. eCollection 2023 Dec.
This case report details the emergency management and successful surgical repair of a tracheoesophageal fistula (TEF) in a newborn delivered by lower segment cesarean section. Despite immediate crying after birth, the neonate's distress was evident, with an Apgar score of 4, prompting an urgent referral to the Neonatal ICU (NICU). Diagnostic investigations, including ultrasonography and two-dimensional echocardiography (2D Echo), revealed associated anomalies, such as a patent ductus arteriosus, arterial septal defect, and a TEF. An anaesthetist was urgently involved due to postnatal desaturation, leading to challenging intubation and surgical repair performed under general anaesthesia, which involved separating the trachea from the oesophagus. Postoperative imaging confirmed the successful closure of the fistulous connection. This case highlights the significance of prompt diagnosis, collaborative management, and surgical intervention in optimising outcomes for neonates with complex congenital anomalies like TEF.
本病例报告详细介绍了一名经下段剖宫产分娩的新生儿气管食管瘘(TEF)的急诊处理及成功的手术修复情况。尽管出生后立即啼哭,但新生儿的窘迫状况明显,阿氏评分4分,遂紧急转诊至新生儿重症监护病房(NICU)。包括超声检查和二维超声心动图(2D Echo)在内的诊断性检查发现了相关异常,如动脉导管未闭、房间隔缺损和气管食管瘘。由于出生后出现低氧血症,紧急请麻醉师会诊,导致插管困难,并在全身麻醉下进行手术修复,手术包括将气管与食管分离。术后影像学检查证实瘘管连接已成功闭合。本病例突出了对于患有如气管食管瘘等复杂先天性畸形的新生儿,及时诊断、协作管理及手术干预对于优化治疗结果的重要性。