Perinatology.  2018 Sep;29(3):142-146. 10.14734/PN.2018.29.3.142.

Successful Treatment of an Unexpected Neonatal Case of Tracheal Agenesis

• Do HJ
• Oh SH
• Park CH

• KMID: 2421581
• DOI: http://doi.org/10.14734/PN.2018.29.3.142

Abstract

Tracheal agenesis is an extremely rare and typically fatal congenital anomaly, with only scattered case reports attesting to of its successful management. This condition usually presents with severe respiratory distress and aphonia after birth. Failed attempts at intubation make neonatal resuscitation difficult. This condition appears to be under-recognized, and there is a lack of consensus regarding the optimum approach for managing this lethal condition. We report herein a rare case of tracheal agenesis and describe our experience, following its successful treatment through surgical management.

Keyword

Tracheal agenesis; Tracheoesophageal fistula; Intubation

MeSH Terms

Aphonia
Consensus
Intubation
Parturition
Resuscitation
Tracheoesophageal Fistula

Figure

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  Fig. 1 Initial infantogram (A) and infantogram after tracheostomy (B). (A) Infantogram shows quite good air content in both lungs, but with fine granular appearance. (B) The lungs have increased air content after tracheostomy.

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  Fig. 2 Pharyngeal non-contrast computed tomography showed no visualization of trachea. (A) At level of C3 vertebral body, (B) at level of C5 vertebral body, (C) at level of C7 vertebral body, tra cheostomy tube insertion site. White arrow indicates esophagus and black arrow indicates tra cheostomy tube.

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  Fig. 3 (A) Pharynx 3 dimension computed tomography showed no visualization of proximal trachea: white arrow indicates esophagus and black arrow indicates distal trachea. (B) Pharyngeal non-contrast computed tomography showed no visualization of trachea at level of C5 vertebral body: thin black arrow indicates C5 vertebral body and thin white arrow indicates esophagus and no visualization proximal trachea.

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  Fig. 4 Floyd's classification of tracheal agenesis by Floyd et al.16 Three types of tracheal agenesis. Type I: atresia of the proximal trachea with presence of the distal trachea and carina and two completely formed bronchi. Type II: the bronchi join in the midline and communicate with the esophagus as a common fistula. Type III: independent communication between the bronchi and esophagus.

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