Keywords
Esophageal Atresia (EA); Tracheo-Esophageal Fistula (TEF); Duodenal Atresia; Anorectal Malformation; Rectovestibular Fistula
Abstract
One day preterm female neonate was presented with excessive drooling of saliva and non passage of meconium since birth to the Department of Pediatric with antenatal history of polyhydramnios detected at 28 weeks followed by fetal distress at 32 weeks which leads to preterm delivery. An X-ray of the chest and abdomen with a nasogastric tube showed coiling of nasogastric tube in the upper oesophageal pouch in the upper chest and a gasless abdomen confirming the diagnosis of pure oesophageal atresia; child had absent anal opening with rectovaginal fistula which was confirmed by passing small feeding tube in the fistula. Oesophagostomy and feeding gastrostomy were done at first surgery. On 2nd postoperative day child developed intolerance and blockage to feed after first few feeds. Contrast dye study done through feeding gastrostomy showed duodenal atresia which was missed during first surgery due to small, collapsed stomach and duodenum due to no gas in the abdomen due to pure oesophageal atresia. Second surgery duodenoduodenostomy was done on 3rd postoperative day of first surgery, but child succumbed postoperatively due to septic shock and prematurity.
Citation
Uplaonkar V, Honnalli C and Shinde N. Congenital Triple Atresia: A Diagnostic Dilemma. SM J Pediatr Surg. 2018; 4(4): 1073.