Spontaneous pneumothorax in a neonate with TEF and double oesophageal atresia. A case report

Abstract

Symptomatic Spontaneous pneumothorax is uncommon disease scenario in term neonates. But pneumothorax can occur in neonates who had CPR or are on mechanical ventilator for different causes of respiratory distress. Congenital double esophageal atresia is a very rare type of esophageal atresia. If only single membranous atresia it can be isolated esophageal membranous atresia or with trachea-esophageal fistula. This type of atresia was not mentioned in gross or Vogt classification. Previously, only a few cases with an obstructing web had been reported and also multiple esophageal atresias. But there is no any documented case report with TEF & multiple esophageal atresia. The choices of treatment vary from ligation of the fistula with excision of the membrane by esophagotomy and/or gastrotomy, thoraco-abdominal approach and end to end anastomoses of the proximal & distal atresia. Here we present a case of a neonate who had developed respiratory distress since birth with a cause of tension spontaneous pneumothorax and managed by a chest tube and also diagnosed to have oesophageal atresia with distal tracheo-esophageal fistula on further evaluation and showing additional distal membranous oesophageal atresia during the thoracotomy. And he was managed accordingly. Keywords: Spontaneous Pneumothorax, esophageal atresia, Membranous atresia, TEF