DOI: 10.21276/sasjs.2019.5.3.7

Pages: 182-186

Congenital Oesophageal Atresia with tracheoesophageal fistula is an uncommon condition. Notable for high mortality due to its pulmonary complications of aspiration and pneumonitis, survival rates have increased markedly with improved neonatal intensive care, surgical technique of repair and nutritional support. We present a neonate who was referred to us at 21 days of age following an inability to pass a nasogastric tube, with excessive drooling of saliva, choking on feeds, fever and weight loss. The patient was diagnosed with oesophageal atresia, distal tracheoesophageal fistula and pneumonitis following a confirmatory chest radiograph. Other anomalies were ruled out and the baby had an initial gastrostomy followed by a right posterolateral thoracotomy, complete disconnection of the fistula, closure of trachea ostium and end-to-end anastomosis of the oesophagus 5 weeks later. Post-operative anastomotic leak occurred and was managed conservatively. Early diagnosis remains invaluable in the management of this condition. This is because aspiration of feeds and chemical pneumonitis is avoided. However, with adequate support and treatment, delayed management may still be successful in the management of these patients.