Congenital tracheobiliary fistula combined with hypoplastic common hepatic duct: Management by percutaneous...

Area of Science:

• Pediatric Surgery
• Developmental Biology
• Gastroenterology

Background:

• Congenital tracheobiliary fistula is a rare anomaly characterized by abnormal communication between the biliary tree and the respiratory tract.
• This condition often presents in neonates and requires prompt diagnosis and management.

Observation:

• A 5-day-old infant presented with bilious secretions in the endotracheal tube, indicative of a potential tracheobiliary fistula.
• The infant also had a hypoplastic common hepatic duct and hypoplastic left heart syndrome, adding complexity to the clinical picture.

Findings:

• Surgical resection successfully treated the congenital tracheobiliary fistula.
• Post-operative cholangiography revealed dilated intrahepatic bile ducts and a residual fistulous tract.
• Transhepatic drainage catheters were used to decompress the biliary system before definitive corrective surgery.

Implications:

• This case underscores the importance of considering rare congenital anomalies in neonates with respiratory and gastrointestinal symptoms.
• Multidisciplinary management involving pediatric surgeons, cardiologists, and gastroenterologists is crucial for optimal outcomes.
• Successful surgical and interventional management can improve prognosis for complex congenital conditions.