Right phrenic nerve palsy following long-gap esophageal atresia and tracheoesophageal fistula repair

Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are surgically correctable congenital anomalies with reported surgical common complications such as anastomotic leaks, recurrent TEF, and esophageal strictures; however, phrenic nerve injury (PNI) is a very rare but possible complication wh...

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Bibliographic Details
Published in:Journal of Indian Association of Pediatric Surgeons 2023-09, Vol.28 (5), p.433-435
Main Authors: Pokharkar, Ashitosh, Aditya, M, Kandpal, Deepak, Balan, Saroja, Gupta, Vidya, Chowdhary, Sujit
Format: Article
Language:English
Subjects:
Babies
Case Report
Case reports
Congenital diseases
Diaphragm (Anatomy)
diaphragmatic palsy
diaphragmatic plication
esophageal atresia
Esophageal diseases
Esophagus
Fistula, Tracheoesophageal
Genetic disorders
Health care
Oxygen therapy
phrenic nerve injury
tracheoesophageal fistula
Ventilators
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Description
Summary:Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are surgically correctable congenital anomalies with reported surgical common complications such as anastomotic leaks, recurrent TEF, and esophageal strictures; however, phrenic nerve injury (PNI) is a very rare but possible complication which we have highlighted in our case report. Here, we report a baby girl operated for long-gap EA and TEF having respiratory distress and failed attempts to wean off oxygen support. Serial chest X-rays showed elevated right hemidiaphragm, whereas ultrasound thorax confirmed our diagnosis of right PNI causing diaphragmatic palsy. Conservative management with the hope of spontaneous recovery failed, so diaphragmatic plication was done at 5 weeks from index surgery. Postplication, the baby was weaned off oxygen and pressure support the very 1st day and had improved respiratory physiology.
ISSN:0971-9261
1998-3891
DOI:10.4103/jiaps.jiaps_7_23