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CC BY 4.0 · European J Pediatr Surg Rep. 2024; 12(01): e20-e22
DOI: 10.1055/a-2227-6252
Case Report

Unintentional Suture Fistula Between the Proximal and Distal Esophagus in a Preterm Neonate with Type C Esophageal Atresia

Julia E. Menso
1   Department of Pediatric Surgery, Amsterdam UMC Location AMC, Amsterdam, North Holland, The Netherlands
,
Maud A. Reijntjes
1   Department of Pediatric Surgery, Amsterdam UMC Location AMC, Amsterdam, North Holland, The Netherlands
,
Carlijn M. Mussies
2   Department of Gastroenterology, Amsterdam UMC Location AMC, Amsterdam, North Holland, The Netherlands
,
Michiel P. van Wijk
2   Department of Gastroenterology, Amsterdam UMC Location AMC, Amsterdam, North Holland, The Netherlands
,
Sander Zwaveling
1   Department of Pediatric Surgery, Amsterdam UMC Location AMC, Amsterdam, North Holland, The Netherlands
› Author Affiliations Funding None.
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Abstract

We present the case of a patient with gross type C esophageal atresia in a preterm neonate (gestational age of 31 weeks + 1 day) with a birth weight of 1,470 g. The fistula was released via a thoracotomy, but no primary anastomosis could be made, due to an unexpected long gap. The distal esophagus was closed and approximated to the blind pouch using traction sutures until an adjacent position was reached. A gastrostomy was created for enteral feeding. Although a second attempt to make an anastomosis was unsuccessful, the patient unexpectedly developed a suture fistula 6 weeks after the first procedure, enabling feeding via a nasogastric tube. Over time, six dilations were necessary. Full enteral feeding was achieved at the age of 6 months. Our case confirms sparse reports that deliberately creating a suture fistula may be a solution in esophageal atresia patients when an unexpected long gap prohibits a primary anastomosis.

Keywords

esophageal atresia - tracheoesophageal fistula - fistula formation

Note

In the realm of pediatric surgery, the creation of a suture fistula may be a potential solution for patients with esophageal atresia. This approach becomes particularly relevant in cases where a considerable gap hinders the possibility of a primary anastomosis.




Publication History

Received: 10 March 2023

Accepted: 10 December 2023

Accepted Manuscript online:
13 December 2023

Article published online:
22 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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