CONGENITAL ESOPHAGEAL ATRESIA SUCCESSFULLY TREATED BY EARLY LIGATION OF A TRACHEOESOPHAGEAL FISTULA AND DELAYED REPAIR OF THE ESOPHAGUS IN A PREMATURE-INFANT - REPORT OF A CASE

We report herein the case of a premature infant with esophageal atresi a (EA) and a tracheoesophageal fistula (TEF) associated with cardiac a nomalies who was successfully treated by an early ligation of the TEF following gastrostomy, and delayed repair of the esophagus, A 1212-g m ale was born prematurely at 31 gestational weeks, at which time he was diagnosed as having EA with TEF and patent ductus arteriosus (PDA), v entricular septal defect (VSD), and atrial septal defect (ASD), A gast rostomy tvas initially performed but following extubation he gradually became tachypneic. A chest roentogenogram revealed atelectasis and gr ound-glass appearance, and reintubation was required. Ligation of the TEF was performed 53h after his birth, Following the improvement of hi s respiratory condition through ventilatory support and the intratrach eal administration of pulmonary surfactant, he underwent repair of the esophagus on the 6th day of life, Postoperatively, he suffered from h eart failure, but was treated with peritoneal dialysis and pharmacolog ical closure of the PDA, Weaning the infant from the ventilator proved difficult, but it was finally achieved when he had reached a weight o f 2268g at 3 months of age by enteral feeding, Our experience of this case demonstrates that early ligation of TEF should be performed for a premature infant with EA and TEF before respiratory distress syndrome (RDS) has developed, If a gastrostomy is required to prevent gastric distention, it should be followed by simultaneous or immediate ligatio n of the TEF.