RARE VARIANTS OF ESOPHAGEAL ATRESIA: A CASE SERIES
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1
Istanbul Medeniyet University Medical School, Pediatric Surgery, Türkiye
Introduction: Rare variants of esophageal atresia (EA) exist in addition to the most commonly encountered forms.
Aim: This study aims to present a case series involving rarely seen variants.
Method: A retrospective evaluation of a 6-year period was done and Kluth’s classification was used. Among 53 patients who underwent EA surgery, five had rare variants. Four were males and one was a female. The mean gestational age was 37 (29-40) weeks and the mean birth weight was 2042 (1310-3200) grams. The female patient who underwent a planned delayed primary repair surgery for isolated atresia, a 2.5-cm long solid cord was found to be connecting the two esophageal ends (Type II3). A primary repair was done. Esophageal continuity was not disrupted in one patient having a high tracheal fistula and an oblique intraluminal membrane (TypeIV5). The membrane was excised with repair of esophageal wall and fistula. He died on the 10th postoperative day due to a major cardiac anomaly. The distal fistula was at the thoracic inlet level and the proximal end was extending about 2 cm below the distal fistula (overlapping ends) in one patient (TypeIIIb4). The esophageal ends had to be “resected” for a successful anastomosis, There were two patients with right main bronchus fistulae (TypeVIb1). One of them underwent primary repair. The other underwent colonic transposition surgery after an initial unsuccessful Foker approximation. The long-term follow-up is uneventful in the four surviving patients with a mean of 39 (30-48) months.
Conclusion: Studies concerning rare variants of esophageal atresia are limited and most are in the form of case reports. Interestingly, rare forms were present in one patient out of 10 in the presented series. Esophageal atresia is the index case for pediatric surgical practice. Intraoperative surprises do happen. Alternative “tailor-made” surgical approaches should be applied whenever necessary.
Keywords:
Esophageal Atresia,
Surgery,
rare,
case,
Children
Conference:
4th International Conference on Oesophageal Atresia / 15-16 September 2016 / Sydney Australia, Sydney, Australia, 15 Sep - 22 Nov, 2016.
Presentation Type:
Poster
Topic:
Difficult surgical decisions in OA
Citation:
Durakbasa
CU,
Gerçel
G,
Fettahoğlu
S,
Mutuş
M,
Okasyalı
MÇ and
Okur
H
(2017). RARE VARIANTS OF ESOPHAGEAL ATRESIA: A CASE SERIES.
Front. Pediatr.
Conference Abstract:
4th International Conference on Oesophageal Atresia / 15-16 September 2016 / Sydney Australia.
doi: 10.3389/conf.FPED.2017.01.000018
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Received:
13 Sep 2016;
Published Online:
11 Dec 2017.
*
Correspondence:
Prof. Cigdem U Durakbasa, Istanbul Medeniyet University Medical School, Pediatric Surgery, İstanbul, Türkiye, cigdemulukaya@yahoo.com