Yamazaki Seirin, Miyazaki Yusuke, Taniguchi Yoshie, Uezono Shoichi
Department of Anesthesiology, The Jikei University School of Medicine, Tokyo, Japan.
JA Clin Rep. 2024 Jul 30;10(1):45. doi: 10.1186/s40981-024-00730-3.
In esophageal atresia type C, identifying the tracheoesophageal fistula (TEF) location is crucial for airway management. However, a thin bronchoscope may not always be available.
We report on a low-birth-weight neonate with esophageal atresia type C who required immediate gastrostomy after birth. With no suitable thin bronchoscope available, alternative methods were utilized to estimate the TEF location post-gastrostomy. Submerging the gastrostomy tube tip in water and applying positive pressure ventilation via a tracheal tube allowed for observation of air bubbles emerging from the gastrostomy tube. As the tracheal tube was advanced, the cessation of bubbles indicated that the TEF was sealed by the tracheal tube. The location of the tracheal tube tip, confirmed by chest radiographs, was consistent with the TEF location identified during corrective surgery for TEF.
This innovative technique facilitated successful estimation of the TEF location without bronchoscopy, demonstrating its efficacy in resource-limited settings.
在C型食管闭锁中,确定气管食管瘘(TEF)的位置对于气道管理至关重要。然而,并非总能获得细支气管镜。
我们报告了一名出生体重低的C型食管闭锁新生儿,出生后需要立即进行胃造口术。由于没有合适的细支气管镜,采用了替代方法来估计胃造口术后TEF的位置。将胃造口管尖端浸入水中,并通过气管导管进行正压通气,以便观察从胃造口管冒出的气泡。随着气管导管向前推进,气泡停止表明TEF被气管导管封闭。经胸部X线片证实的气管导管尖端位置与TEF矫正手术中确定的TEF位置一致。
这项创新技术有助于在不进行支气管镜检查的情况下成功估计TEF位置,证明了其在资源有限环境中的有效性。