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Esophageal atresia with tracheoesophageal fistula: two case reports

Naomi A Mwamanenge1, Haika K Mariki2, Lucy L Mpayo2

  • 1Muhimbili University of Health and Allied Sciences (Muhas), P. O box 65001, Dar es Salaam, Tanzania. naomimwams@gmail.com.

Journal of Medical Case Reports
|December 30, 2023
PubMed

Insights

Infants with esophageal atresia and tracheoesophageal fistula (EA/TEF) face poor outcomes in lower-middle-income countries due to delayed care. Early intervention and stable preoperative condition significantly improve survival rates for EA/TEF patients.

Area of Science:

  • Pediatric Surgery
  • Neonatal Care
  • Congenital Anomalies

Background:

  • Esophageal atresia with tracheoesophageal fistula (EA/TEF) affects 1 in 3000-5000 live births globally.
  • Outcomes for EA/TEF infants in lower-middle-income countries (LMICs) are often poor.
  • Common challenges include aspiration, sepsis, delayed referral, and postoperative complications.

Observation:

  • Two cases of EA/TEF in African neonates are presented: a 2-day-old male and a 5-day-old female.
  • The 5-day-old infant, presenting with sepsis, required preoperative stabilization and had a poor outcome.
  • The 2-day-old infant, who was preoperatively stable, experienced a good postoperative outcome.

Findings:

  • Delayed referral and sepsis significantly impact EA/TEF infant outcomes in LMICs.
  • Postoperative complications like anastomosis leaks, pneumonia, and pneumothorax contribute to poor healing.
  • Preoperative stability and timely management are crucial for improved outcomes in EA/TEF cases.

Implications:

  • Highlights the critical need for timely referral and management of EA/TEF in LMICs.
  • Emphasizes the importance of addressing sepsis and ensuring preoperative stability for better surgical results.
  • Suggests that improved healthcare infrastructure and early intervention can enhance survival rates for infants with EA/TEF.
Abstract

Keywords:
Anastomosis leakEsophageal atresiaPneumothoraxSepsisTracheoesophageal fistula

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