Esophageal Reconstruction with Gastric Pull-up in a Premature Infant with Type B Esophageal Atresia.
- Author:
Young Mi HAN
1
;
Narae LEE
;
Shin Yun BYUN
;
Soo Hong KIM
;
Yong Hoon CHO
;
Hae Young KIM
Author Information
- Publication Type:Case Report
- Keywords: Esophageal atresia; Tracheoesophageal fistula; Premature infant
- MeSH: Body Weight; Bronchoscopy; Diagnosis; Diet; Enteral Nutrition; Esophageal Atresia*; Esophagostomy; Fetal Growth Retardation; Fistula; Gastrostomy; Humans; Infant; Infant, Newborn; Infant, Premature*; Male; Parturition; Pneumonia; Pregnancy; Stomach; Tracheoesophageal Fistula
- From:Neonatal Medicine 2018;25(4):186-190
- CountryRepublic of Korea
- Language:English
- Abstract: Esophageal atresia (EA) with proximal tracheoesophageal fistula (TEF; gross type B) is a rare defect. Although most patients have long-gap EA, there are still no established surgical guidelines. A premature male infant with symmetric intrauterine growth retardation (birth weight, 1,616 g) was born at 35 weeks and 5 days of gestation. The initial diagnosis was pure EA (gross type A) based on failure to pass an orogastric tube and the absence of stomach gas. A “feed and grow” approach was implemented, with gastrostomy performed on postnatal day 2. A fistula was detected during bronchoscopy for recurrent pneumonia; thus, we confirmed type B EA and performed TEF excision and cervical end esophagostomy. As the infant's stomach volume was insufficient for bolus feeding after reaching a body weight of 2.5 kg, continuous tube feeding was provided through a gastrojejunal tube. On the basis of these findings, esophageal reconstruction with gastric pull-up was performed on postnatal day 141 (infant weight, 4.7 kg), and he was discharged 21 days postoperatively. At 12 months after birth, there was no catch-up growth; however, he is currently receiving a baby food diet without any complications. In patients with EA, bronchoscopy is useful for confirming TEF, whereas for those with long-gap EA with a small stomach volume, esophageal reconstruction with gastric pull-up after continuous feeding through a gastrojejunal tube is worth considering.
