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Tracheoplasty using the thymus against tracheo‐esophageal fistula due to necrotizing tracheobronchitis in a very low birth weight infant
Author(s) -
Hasegawa Hisaya,
Nagase Yuzo,
Sakai Miho,
Henmi Nobuhide,
Tsuruta Shio
Publication year - 2014
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23023
Subject(s) - medicine , fistula , tracheomalacia , malacia , surgery , tracheoesophageal fistula , low birth weight , pneumonia , airway , pregnancy , biology , genetics
Summary We report a case of a very low birth weight infant treated successfully with tracheoplasty using the thymus against tracheo‐esophageal fistula due to necrotizing tracheobronchitis. A baby boy was born at 31 weeks gestation with a birth body weight of 1,230 g. Suddenly on Day 19, his respiration deteriorated, and a flexible bronchofiberscopy showed tracheostenosis, tracheomalacia, and tracheal diverticula. On Day 21, his abdomen became significantly distended, and a flexible bronchofiberscopy showed a tracheo‐esophageal fistula due to a rupture of the diverticula. On Day 105, during surgery, we confirmed necrosis of the trachea. Because the lesion was widespread, we used the thymus for tracheoplasty and closure of the tracheo‐esophageal fistula. His post‐operative course went well, and was discharged at 1 year 9 months of age. Now, 8 years after the operation, although he still needs a T‐tube airway management through tracheostomy, he has achieved speech, normal growth and development, and takes regular classes at school. Tracheoplasty using the thymus is thought to be a treatment worth considering when there are no other effective alternative treatments for tracheo‐esophageal fistula due to necrotizing tracheobronchitis. Pediatr Pulmonol. 2014; 49:E135–E139. © 2014 Wiley Periodicals, Inc.