Laryngotracheoesophageal cleft in a newborn

A case of laryngotracheoesophageal cleft in a newborn is presented. A newborn presenting with respiratory distress underwent contrast radiographic studies, direct laryngoscopy, bronchoscopy, and esophagoscopy, demonstrating a complete laryngotracheoesophageal cleft, esophageal diverticulum and microgastria. Attempts to maintain an adequate airway by ligation of the salivary ducts and ligation of the distal esophagus were unsuccessful. Continued biliary drainage per endotracheal tube postoperatively afforded a presumptive diagnosis of bronchobiliary fistula. The child expired on its fourth day of life. A review of the literature and modalities of therapy for these rare and unusual combinations of foregut anomalies is discussed. This is the first reported case of a newborn with the combination of laryngotracheoesophageal cleft, bronchobiliary fistula, microgastria and esophageal diverticulum.