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Management of patients with combined tracheoesophageal fistula, esophageal atresia, and duodenal atresia.

AbstractINTRODUCTION:
Patients with combined esophageal atresia (EA), tracheoesophageal fistula (TEF), and duodenal atresia (DA) pose a rare management challenge.
PRESENTATION OF CASE:
Three patients with combined esophageal atresia (EA), tracheoesophageal fistula (TEF), and duodenal atresia safely underwent a staged approach inserting a gastrostomy tube and repairing the EA/TEF first followed by a duodenoduodenostomy within one week. None of the patients suffered significant pre- or post-operative complications and our follow-up data (between 12 and 24 months) suggest that all patients eventually outgrow their reflux and respiratory symptoms.
DISCUSSION:
While some authors support repair of all defects in one surgery, we recommend a staged approach. A gastrostomy tube is placed first for gastric decompression before TEF ligation and EA repair can be safely undertaken. The repair of the DA can then be performed within 3-7 days under controlled circumstances.
CONCLUSION:
A staged approach of inserting a gastrostomy tube and repairing the EA/TEF first followed by a duodenoduodenostomy within one week resulted in excellent outcomes.
AuthorsChristoph S Nabzdyk, Bill Chiu, Carl-Christian Jackson, Walter J Chwals
JournalInternational journal of surgery case reports (Int J Surg Case Rep) Vol. 5 Issue 12 Pg. 1288-91 ( 2014) ISSN: 2210-2612 [Print] Netherlands
PMID25460495 (Publication Type: Journal Article)
CopyrightCopyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

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