Unilateral pulmonary agenesis associated with oesophageal atresia and tracheoesophageal fistula: A case report with prenatal diagnosis

Go Miyano, Keiichi Morita, Masakatsu Kaneshiro, Hiromu Miyake, Mariko Koyama, Hiroshi Nouso, Masaya Yamoto, Reiji Nakano, Yasuhiko Tanaka, Tomizo Nishiguchi, Takakazu Kawamura, Koji Fukumoto, Naoto Urushihara

Research output: Contribution to journalArticle

Abstract

We describe herein a case of unilateral pulmonary agenesis (PA) with oesophageal atresia (EA)/tracheoesophageal fistula (TEF) that was diagnosed prenatally and repaired by esophagoesophagostomy with stable postoperative course. The patient was born at 34 weeks gestation, after ultrasonography at 22 weeks gestation showed possible right-sided diaphragmatic eventration or PA and EA was subsequently suspected due to hydramnios. The initial X-ray showed mediastinal shift to the right, and coil up sign of the nasogastric tube, without intracardiac anomaly. Immediately after the diagnosis of EA/TEF and unilateral PA on day 0, the patient was intubated in the operating room, and a gastrostomy tube was placed. After pulmonary status stabilized, at 4 days old, EA/TEF was repaired through a thoracotomy in the right 4 th intercostal space. The right main bronchus was noted to continue into the distal oesophagus; this fistula was ligated and divided, and a single-layer esophagoesophagostomy was performed under mild tension with one vertebral gap. The neonate was maintained on mechanical ventilation and gradually weaned to extubation at 7 days old. The postoperative course was uneventful, with the exception of prolonged jaundice that emerged at 3 months old. Laparoscopic cholangiography at that time excluded biliary atresia, and jaundice resolved spontaneously. The patient has not shown any respiratory symptoms or feeding difficulties as of the 12-month follow-up.

Original languageEnglish
Pages (from-to)86-88
Number of pages3
JournalAfrican Journal of Paediatric Surgery
Volume12
Issue number1
DOIs
Publication statusPublished - Feb 1 2015
Externally publishedYes

Keywords

  • Oesophageal atresia
  • tracheoesophageal fistula
  • unilateral pulmonary agenesis

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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  • Cite this

    Miyano, G., Morita, K., Kaneshiro, M., Miyake, H., Koyama, M., Nouso, H., Yamoto, M., Nakano, R., Tanaka, Y., Nishiguchi, T., Kawamura, T., Fukumoto, K., & Urushihara, N. (2015). Unilateral pulmonary agenesis associated with oesophageal atresia and tracheoesophageal fistula: A case report with prenatal diagnosis. African Journal of Paediatric Surgery, 12(1), 86-88. https://doi.org/10.4103/0189-6725.151000