A 1000-gram, 28 weeks’ gestational age male neonate was born followinga premature labor. The infant

A 1000-gram, 28 weeks’ gestational age male neonate was born followinga premature labor. The infant did not have a respiratory rate of effort at birth despite resuscitation efforts. An orogastric tube was placed to decompress the stomach, the infant was intubated, me-chanically ventilated and transferred to the NICU. Upon admission mechanical ventilation was provided. On day 2 of life, the patient was noted to have significant abdominal distension. Chest radiograph revealed a pneumoperitoneum and the orogastric tube was noted to terminate in the proximal stomach. On day 3 of life, significant distention was noted on examination. An abdominal X-ray demonstrated persistent intraperitoneal air. The stomach was distended, and air was seen to be leaking from the stomach with each mechanical breath delivered. A TEF was suspected. Bronchoscopy was then performed which confirmed the diagnosis. A bedside thoracotomy was then performed, with the infant placed in the left lateral position. The infant was found to have a proximal esophageal atresia through which the initial orograstric tube had perforated and was lying on top of the diaphragm. The TEF was identified and ligated. A primary esoph-ageal anastomosis was performed over a 5 Fr feeding tube. The area between the anastomosis and the tracheal fistula closure was rein-forced surgically. The patient received ventilatory assistance and supportive care in the NICU post-operatively. The patient was weaned from mechanical ventilatory support on day 95 of life, and was discharged home on day 110 of life with a weight of 2830 grams. He was doing well and tolerating full feeds through a gastrostomy tube.1. Describe a tracheoesophageal fistula.2. What are the two types of surgical options for TEF?3. Explain the clinical manifestations of TEF. Health Science Science Nursing SCIENCE / RSPT Share QuestionEmailCopy link Comments (0)

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