SURGICAL MANAGEMENT OF NEONATE PRESENTING WITH TYPE 3 B 4 VARIETY OF TEF (KLUTH)

Authors: dr. sukrit singh shah, dr. vikram Khanna

DOI: 10.18231/j.ijpns.13341.1759839987

Keywords: tracheoesophageal fistula,anastomotic l,NEONATES,NEONATAL SURGERY

Abstract: TEF is a common neonatal surgical emergency that presents shortly after birth with drooling of saliva from the mouth, inability to feed, and respiratory distress with or without cyanosis. The definitive treatment for this condition is surgery. Essentially the defect involves agenesis of a part of the esophagus with a fistulous communication with the trachea. There are a large number of anatomical variants of this anomaly, Kluth has described nearly 96 different varieties. The type B variety involves a blind-ending upper pouch with a fistulous communication between the lower pouch and the trachea. There are 20 subtypes described for type B anomaly. Type 3b4 variety involves the overlapping upper and lower esophageal pouches. The long TEF courses parallel in proximity to the upper pouch (UP) and the trachea. This mandates a very meticulous dissection of the upper pouch from the trachea. In this case report, we describe how an on-table diagnosis of this variant forced us to modify the steps of dissection so as to prevent tracheal injury.