Isolated congenital tracheal stenosis in a preterm newborn

• Published in: European journal of pediatrics 2011-09, Vol.170 (9), p.1217-1221
• Main Authors: Krause, Ulrich, Rödel, Ralph M. W., Paul, Thomas
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Births; Cardiopulmonary resuscitation; Cartilage; Complex syndromes; Connective tissue; CPR; Esophagus; Fatal Outcome; Fistula; General aspects; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - pathology; Intensive care; Intubation; Larynx; Lungs; Male; Medical genetics; Medical sciences; Medicine; Medicine & Public Health; Narcotics; Otolaryngology; Pediatrics; Pneumology; Respiratory failure; Respiratory system : syndromes and miscellaneous diseases; Short Report; Substance abuse treatment; Trachea - abnormalities; Tracheal Stenosis - congenital; Tracheal Stenosis - pathology; Tracheotomy; Ventilators
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-011-1490-x

Severe tracheal stenosis, resulting in functional atresia of the trachea is a rare congenital malformation with an estimated occurrence of two in 100,000 newborns. If no esophagotracheal fistula is present to allow for spontaneous breathing, this condition is usually fatal. We report on a male infant born at 32 weeks of gestation. The patient presented with respiratory distress immediately after delivery due to severe congenital tracheal stenosis resulting in functional atresia of the trachea. Endotracheal intubation failed and even emergency tracheotomy did not allow ventilation of the patient lungs. The patient finally succumbed to prolonged hypoxia due to functional tracheal atresia. The etiology of tracheal atresia and tracheal stenosis is still unclear, but both conditions are frequently combined with other anomalies of the VACTERL (vertebral anomalies, anal atresia, cardiovascular anomalies, tracheoesophageal fistula, esophageal atresia, renal/radial anomalies and limb defects) and TACRD (tracheal agenesis, cardiac, renal and duodenal malformations) association. Conclusion Successful treatment of severe congenital tracheal stenosis and tracheal atresia depends on either prenatal diagnosis or recognition of this condition immediately after birth to perform tracheotomy without delay. Nevertheless, despite any efforts, the therapeutical results of severe tracheal stenosis and tracheal atresia are still unsatisfactory.