PUNE: A city-based hospital performed two corrective surgeries on a newborn baby with tracheoesophageal fistula, the defect which abnormally connects the oesophagus and the trachea. Along with this, the baby also had Patent Ductus Arteriosus (PDA), a rare disease of the heart.
Though the baby was healthy and weighing 2.5 kg, the doctors had a complex case at hand as the baby did not have any anal opening.
Dr Pranav Jadhav, Paediatric Surgery, Dr Ganesh Badge, Consultant - Pediatric ICU at Columbia Asia Hospital performed the surgery to correct the abnormal connection between the oesophagus and the trachea and also performed colostomy on the child to create the anal opening.
According to doctors, tracheoesophageal fistula occurs in one out of 300 to 4,500 live births and is manifested within a few hours of birth.
In this case, the newborn had excessive frothing and respiratory distress after birth and was shifted to the Neonatal Intensive Care Unit (NICU) at the hospital.
Dr Ganesh Badge, Paediatric Surgery, Columbia Asia Hospital, said that in cases of tracheoesophageal fistula, there is a high chance that the acid formed in the stomach reaches the lungs which can eventually develop pneumonia.
“The surgery is a critical one which has about 10 per cent chances of death. It took 3 to 4 hours to complete the surgery under full anaesthesia. However, post-operative care was crucial for recuperation. The baby was kept for three days on a ventilator in an upright position to prevent the stomach’s acid reaching the lungs. Besides, we also used frequent suctioning and managed a nasogastric tube to facilitate breathing. The baby’s blood pressure was low, hence we had to provide drugs to increase the force or speed of contraction of heart muscles,” said Badge.
He added that since the child had an abnormal connection between the food and windpipes, he was in NICU since birth.
“The case was managed well and the baby did not develop sepsis or hypoglycaemia while his stay at the NICU. We trained the mother in colostomy wound care, how to clean after the child passes stool and general dressing,” said Dr Badge.
“During the follow-up visit after a month, the baby was well and gained good weight. After 10 days of the surgery, the baby had started to breastfeed,” he furthur informed.
COMPLICATIONS IN THE CASE
- In tracheoesophageal fistula, the oesophagus (food pipe) is abnormally connected with the trachea (windpipe).
- The newborn had Patent Ductus Arteriosus (PDA), which is a rare disease of the heart in which the connection between the aorta and pulmonary artery remains open after birth, instead of closing.
