An unusual cause of salivary leak post tracheoesophageal fistula repair

Jardine, Luke A. and Kimble, Roy M. (2008) An unusual cause of salivary leak post tracheoesophageal fistula repair. Pediatric Surgery International, 24 4: 443-445. doi:10.1007/s00383-007-1918-6

Author Jardine, Luke A.
Kimble, Roy M.
Title An unusual cause of salivary leak post tracheoesophageal fistula repair
Journal name Pediatric Surgery International   Check publisher's open access policy
ISSN 0179-0358
Publication date 2008-04
Year available 2007
Sub-type Article (original research)
DOI 10.1007/s00383-007-1918-6
Volume 24
Issue 4
Start page 443
End page 445
Total pages 3
Editor P. Puri
A. G. Coran
Place of publication Heidelberg, Germany
Publisher Springer
Collection year 2009
Language eng
Subject 320100 Medicine - General
920118 Surgical Methods and Procedures
321019 Paediatrics
321029 Surgery
Abstract LB was a male infant born via spontaneous vaginal delivery at term in a peripheral centre. A provisional diagnosis of oesophageal atresia (OA) with tracheoesophageal fistula (TOF) was made and the child was transferred to a tertiary centre for further evaluation. On day two of life he underwent repair of his oesophageal atresia and division of his distal tracheoesophageal fistula. The upper and lower oesophageal segments were brought together with average tension. An extrapleural drain was inserted with the tip sutured close to the anastomosis. His post-operative course was complicated by two failed extubations secondary to respiratory distress and the development of a salivary leak. Despite repositioning of the extrapleural drain on two separate occasions, the salivary leak continued. Day 25 post-operatively he underwent direct laryngoscopy, bronchoscopy and oesophagoscopy. The extrapleural drain was found to be causing tracheal compression and the tip of the drain was located within the lumen of the oesophagus. Saliva leak is not an uncommon complication of this oesophageal atresia repair. This is the first report of an extrapleural drain being found in the oesophagus causing salivary leak and tracheal compression. These complications may have been prevented by ensuring the drain did not impinge on the anastomosis site, by pulling the drain back at an earlier time or by not having used an extrapleural drain at all.
Keyword Tracheoesophageal fistula
Infant, newborn
Case reports
Postoperative complications
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Epub Apr 12 2007

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Created: Tue, 14 Apr 2009, 15:39:58 EST