The premature male baby, 33 weeks gestation with 2.3kg, was born through the spontaneous normal delivery, this premature baby demonstrated copious salivary secretion, mild aspiration pneumonia episode and intermittent cyanotic events immediately
after
birth.
Adequate treatment was done with head up position. Frequent upper pouch suction and adequate fluid and antibiotic theraphy in incubator.
Roentgen examination of combined chest abdomen was revealed large amount of gas shadow in the stomach and a haziness in right lower lung field with shifted mediastinum to the right side.
Esophagogram was revealed large blind pouch on the proximal esophagus, and Two dimensional echocardiography showed the Ventricular Septal Defect.
The final diagnosis was made as congenital esophageal atresia with tracheoesophageal fistula (Vogt-Gross type C, Waterston Risk Category B), inccluding congenital heart disease, most probably Ventricular Septal Defect.
After the cannulation of umbilical vein for fluid theraphy and preliminary decompressive gastrostomy, surgical correction using Beardmore anastomosis was underwent through the right posterolateral thoracotomy approach.
The postoperative course was very smooth and noneventful, and postoperative follow-up esophagogram showed smooth passage of contrast to stomach without stricture evidence, but after postoperative about 1 month, mild stricture was noted and
relieved
by
balloon dilatation.
After adequate treatment for about one month in incubator, the baby was discharged with good general condition and normal weight 3.35kg. (Korean J Thoracic Cardiovas Surg 1994; 27:489-93)
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