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      Kluth Type IIIb 6 Esophageal Atresia: Diagnostic Dilemma and Pitfalls of Using Infant Feeding Tube

      case-report

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          Abstract

          We describe three male neonates where infant feeding tube (IFT) passed 18–20 cm in the upper esophageal pouch. A blunt-tipped red rubber catheter confirmed esophageal atresia (EA) with long upper pouch in all three cases. Definitive management revealed EA with tracheoesophageal fistula and long overlapping upper esophageal pouch consistent with Kluth Type IIIb 6 variant in two patients. Importance of using red rubber catheter at the pediatric practice instead of IFT is stressed.

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          Atlas of esophageal atresia.

          D Kluth (1976)
          Article 0 comments Cited 12 times – based on 0 reviews     Review now
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            Esophageal atresia. Prognostic factors and contribution of preoperative telescopic endoscopy.

            H Filston, J S Rankin, J K Grimm (1984)
            In recent years, the surgical correction of esophageal atresia with distal tracheoesophageal fistula (TEF) has become increasingly successful. However, there remains a group of high-risk patients with specific anatomical abnormalities in whom the mortality remains appreciable. These associated disorders include cardiac, renal, and chromosomal anomalies as well as severe respiratory distress syndrome. These factors, rather than low birth weight or early gestational age, are primarily responsible for surgical mortality. Preoperative telescopic bronchoscopy has been a useful adjuvant confirming the diagnosis, identifying unusual variants, and permitting the proper anatomic placement of the endotracheal tube. A Fogarty balloon catheter can be passed bronchoscopically into the distal TEF in patients with severe respiratory distress syndrome to occlude the fistula and facilitate effective positive pressure ventilation. Thirty-two patients were treated for esophageal atresia among whom 28 had esophageal atresia with distal TEF, three had esophageal atresia alone, and one had esophageal atresia with proximal TEF. The higher-risk group comprised those with severe respiratory insufficiency as evidenced by a room air paO2 of less than 60 mmHg; this group accounted for nine of the ten deaths in the total series. There was one late death following surgical correction. In summary, in the absence of severe respiratory insufficiency or associated life-threatening congenital anomalies, the results of surgical correction for esophageal atresia are remarkably good and survival in this group approximates 100%.
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              A preoperative diagnostic challenge of a long overlapping upper pouch with distal tracheoesophageal fistula

              T Kondo, S HONDA, M. MINATO … (2015)
              Article 0 comments Cited 2 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Indian Assoc Pediatr Surg
                Journal ID (iso-abbrev): J Indian Assoc Pediatr Surg
                Journal ID (publisher-id): JIAPS
                Title: Journal of Indian Association of Pediatric Surgeons
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0971-9261
                ISSN (Electronic): 1998-3891
                Publication date (Print): Apr-Jun 2018
                Volume: 23
                Issue: 2
                Pages: 96-99
                Affiliations
                [1]Department of Paediatric Surgery, Kota Medical College, Kota, India
                [1 ]Department of Paediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India
                Author notes
                Address for correspondence: Dr. Rahul Gupta, Department of Paediatric Surgery, Kota Medical College, Kota, Rajasthan, India. E-mail: meetsurgeon007@ 123456yahoo.co.in
                Article
                Publisher ID: JIAPS-23-96
                DOI: 10.4103/jiaps.JIAPS_181_17
                PMC ID: 5898213
                SO-VID: 72dc83d9-257e-4cb5-9e9e-c4654522eff8
                Copyright © Copyright: © 2018 Journal of Indian Association of Pediatric Surgeons
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Date received : September 2017
                Date accepted : February 2018
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Keywords: esophageal atresia,kluth type iiib6,long overlapping upper pouch,red rubber catheter
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: esophageal atresia, kluth type iiib6, long overlapping upper pouch, red rubber catheter

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