Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Case Report
Editorial
Journal Review
Letter to Editor
Letter to the Editor
Original Article
Review Article
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Case Report
Editorial
Journal Review
Letter to Editor
Letter to the Editor
Original Article
Review Article
View/Download PDF

Translate this page into:

Case Report
36 (
4
); 171-173
doi:
10.25259/KPJ_26_2021

A rare association of esophageal atresia and tracheoesophageal fistula with microgastria: A case report

Department of Pediatric Surgery, SDM College of Medical Science and Hospital, Dharwad, Karnataka, India
Department of Pediatrics, SDM College of Medical Science and Hospital, Dharwad, Karnataka, India
Corresponding author: Prashant K. Zulpi, Department of Pediatric Surgery, SDM College of Medical Science and Hospital, Dharwad, Karnataka, India. prashantkzulpi@gmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Zulpi PK, Halgeri AB, Kalavant BA, Kulkarni VK. A rare association of esophageal atresia with tracheoesophageal fistula with microgastria: A case report. Karnataka Paediatr J 2021;36:171-3.

Abstract

We present a case of esophageal atresia with tracheoesophageal fistula which was associated with microgastria. Following primary esophageal anastamosis developed leak and went into severe sepsis and died.

Keywords

Esophageal atresia
Tracheoesophageal fistula
Microgastria

INTRODUCTION

Congenital microgastria is a rare anomaly of the stomach resulting from abnormal development of the foregut. This results in tubular stomach with reduced capacity. It is almost always associated with other congenital anomalies.[1] Association of tracheoesophageal fistula (TEF) with microgastria is a very rare entity.

CASE REPORT

A 1.5 kg preterm was born by LSCS to a primigravida mother of 26 years. Baby was born with drooling of saliva and was kept in NICU. On radiological evaluation was found to have [Figure 1] coiling of tube with absent gastric shadow. However, minimal bowel shadows noted distally. Baby was taken for emergency surgery on day 1 of life. Intraoperatively was found to have esophageal atresia with TEF (Type C) with long gap. Anastomosis is done under tension [Figure 2]. Trans-anastomotic tube was going with difficulty; hence, laparotomy was done and found to have microgastria [Figure 3]. The stomach was so small, tubular could not be delivered outside for gastrostomy; hence, feeding jejunostomy was done. Postoperatively baby was under ventilator support. Later developed anastomotic leak and sepsis following which baby died.

Figure 1:: Baby gram showing coiling of tube I upper pouch with absent stomach shadow and minimal distal bowel shadow.
Figure 2:: Showing esophageal anastomosis under tension.
Figure 3:: Intraoperatively showing small stomach.

DISCUSSION

Esophageal atresia with tracheoesophageal fistula in association with microgastria is very rare. Several other anomalies are reported in association with microgastria. Microgastria is characterized by megaesophagus with incompetence of gastroesophageal sphincter.[2] Isolated microgastria is very rare and very few are reported in literature.[3] The diagnosis of microgastria is usually made by upper gastrointestinal dye study which shows small tubular stomach in midline.

In our case, pre-operative baby gram showing absent stomach shadow was a highlighting finding in the presence of minimal distal bowel shadow. Treatment of microgastria can be conservative (or) surgical, depending on severity of microgastria. Conservative treatment includes continuous small frequent feeds (nasogastric/ naso-jejunal feeds).[4] Surgical intervention includes gastric augmentation by creation of Hunt-Lawrence pouch have been described.[5,6]

CONCLUSION

A high view of suspicion must be considered in TEF babies if baby gram shows coiling with absence of stomach shadows in presence of minimal bowel shadows.

Cervical esophagostomy could probably save baby instead of primary anastomosis.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. , . An eighteen year follow-up after surgery for congenital microgastria-case report and review of literature. J Pediatr Surg. 2007;42:1957-60.
    [CrossRef] [PubMed] [Google Scholar]
  2. , , . Congenital microgastria. J Pediatr Surg. 1994;29:1591-3.
    [CrossRef] [Google Scholar]
  3. , , . Microgastria as an isolated anomaly. J Pediatr Surg. 1996;31:1445-7.
    [CrossRef] [Google Scholar]
  4. , , , . Management of congenital microgastria. J Pediatr Surg. 1990;25:192-7.
    [CrossRef] [Google Scholar]
  5. , , , . Congenital microgastria and dumping syndrome. J Pediatr Surg. 1983;18:747-50.
    [CrossRef] [Google Scholar]
  6. , , . Congenital microgastria in a premature infant. J Pediatr Surg. 1994;29:1594-5.
    [CrossRef] [Google Scholar]
Show Sections