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Eur J Pediatr Surg 2013; 23(02): 153-156
DOI: 10.1055/s-0032-1315805
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Georg Thieme Verlag KG Stuttgart · New York

Recurrent Tracheoesophageal Fistula and Respiratory Failure: The Role of Early Airway Endoscopic Approach

Marco Piastra
1   Department of Emergency, Pediatric Intensive Care Unit, Catholic University of the Sacred Heart, Rome, Italy
,
Vito Briganti
2   Division of Pediatric Surgery, Department of Pediatrics, “S. Camillo-Forlanini” Hospital, Rome, Italy
,
Ersilia Luca
1   Department of Emergency, Pediatric Intensive Care Unit, Catholic University of the Sacred Heart, Rome, Italy
,
Maria Pia De Carolis
3   Division of Neonatology, Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy
,
Pietrini Domenico
1   Department of Emergency, Pediatric Intensive Care Unit, Catholic University of the Sacred Heart, Rome, Italy
,
Giorgio Conti
1   Department of Emergency, Pediatric Intensive Care Unit, Catholic University of the Sacred Heart, Rome, Italy
,
Eleonora Stival
1   Department of Emergency, Pediatric Intensive Care Unit, Catholic University of the Sacred Heart, Rome, Italy
,
Alessia Tempera
4   Division of Neonatology, Department of Pediatrics, “S. Camillo-Forlanini” Hospital, Rome, Italy
,
Alessandro Calisti
2   Division of Pediatric Surgery, Department of Pediatrics, “S. Camillo-Forlanini” Hospital, Rome, Italy
,
Paola Serio
5   Department of Intensive Care, “A. Meyer” Children Hospital, Florence, Italy
› Author Affiliations
Further Information

Publication History

10 January 2012

21 April 2012

Publication Date:
10 July 2012 (online)

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Introduction

Tracheoesophageal fistulas (TEFs) represent uncommon congenital communications between esophagus and trachea and despite precocious surgical repair their recurrence still represents an important challenge for pediatric surgeons. Recurrence of the TEF occurs in ~9% of cases, most often 2 to 18 months after initial repair.[1]

While respiratory symptoms have been reported frequently (22/26 cases of recurrent TEF by Bruch et al[2]), the occurrence of severe respiratory failure in association to TEF is quite uncommon. In fact, symptoms are often difficult to differentiate from tracheomalacia or gastroesophageal reflux, commonly found in infants with repaired esophageal atresia (EA)/TEF. Bronchoscopy may be used in intensive care setting both to confirm diagnosis and to treat lesions. Fistula treatment may be definitive or even transient, permitting pulmonary condition improvement and delay in surgical repair.

 

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