Shimamoto T, Fukuda K
Department of Anesthesia, Kyoto University Hospital.
Masui. 1997 Aug;46(8):1090-3.
We report anesthetic management of a patient with laryngotracheoesophageal cleft which lacks partition between the esophagus and upper airway, a rare congenital anomaly with a high mortality. A male baby weighting 2.96 kg was born at 39-week gestation. He had respiratory distress, hoarse cry and cyanosis on feeding. Gastric cardioplasty was scheduled at the age of 10 days, under the presumptive diagnosis of gastroesophageal regurgitation. Endotracheal intubation was performed and anesthesia with 1-3% sevoflurane and 100% oxygen was started. However, SpO2 dropped suddenly and transiently. Endoscopic examination performed transnasally and through the endotracheal tube demonstrated that the septum between the trachea and esophagus was absent from the larynx through the entire length of the trachea. On the basis of these finding, this case was diagnosed as laryngotracheoesophageal cleft (type 3). Esophageal division and gastrostomy were performed to prevent regurgitation and aspiration of gastric content.
我们报告了一例喉气管食管裂患者的麻醉管理情况。喉气管食管裂是一种食管与上呼吸道之间缺乏分隔的罕见先天性畸形，死亡率很高。一名体重2.96千克的男婴在孕39周时出生。他有呼吸窘迫、哭声嘶哑和喂食时发绀的症状。在初步诊断为胃食管反流的情况下，计划在患儿10日龄时进行胃底折叠术。进行了气管插管，并开始使用1% - 3%的七氟醚和100%的氧气进行麻醉。然而，血氧饱和度（SpO2）突然短暂下降。经鼻并通过气管导管进行的内镜检查显示，从喉部到气管全长，气管与食管之间均无隔膜。基于这些发现，该病例被诊断为喉气管食管裂（3型）。为防止胃内容物反流和误吸，进行了食管分隔术和胃造口术。
