Life-threatening anoxic spells caused by tracheal compression after repair of esophageal atresia: Correction by surgery |
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Authors: | Robert M. Filler Pedro J. Rossello Robert L. Lebowitz |
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Affiliation: | Department of Surgery and Radiology, Children''s Hospital Medical Center, and the Harvard Medical School, Boston, Mass., USA |
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Abstract: | Three infants who developed anoxic spells 2, 5, and 20 mo following repair of esophageal atresia developed apneic spells during or within a few minutes of feeding. These episodes began with stridor and cyanosis; when severe, they progressed to apnea and loss of consciousness. Mouth-to-mouth resuscitation was often necessary. Investigations failed to detect esophageal obstruction and/or a recurrent tracheoesophageal fistula. No neurologic or cardiac abnormalities were found. The cause was compression of a 1- to 3-cm segment of trachea anteriorly by a vascular structure and posteriorly by a dilated esophagus that emptied slowly because of poor motility. Endoscopy confirmed the x-ray findings. The aortic arch and innominate artery were suspended to the sternum anteriorly, which relieved the apneic spells in all patients. |
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Keywords: | Address for reprint requests: Robert M. Filler M.D. Children's Hospital Medical Center 300 Longwood Ave. Boston Mass. 02115. |
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