Bronchoscopic Obliteration of Recurrent Tracheoesophageal Fistula in an Infant

Abstract

This report describes the use of cautery and fibrin glue applied via rigid bronchoscopy to obliterate a recurrent tracheoesophageal fistula (TEF) in an infant who had undergone repair of congenital esophageal atresia and TEF without a proximal fistula on day of life (DOL) 2 by division of the TEF with end-to-end anastomosis of the esophagus. She fed uneventfully and was discharged on DOL 11. Two months later, the child began coughing while feeding, and a contrast study showed a recurrent TEF. She underwent rigid bronchoscopy and cauterization of the fistula with an insulated wire followed by application of fibrin glue. This procedure was carried out three times at weekly intervals. Feeding was accomplished via nasogastric tube. The patient continues to eat well almost 3.5 years later. Recurrent TEF may be obliterated with application of cautery and fibrin glue via rigid bronchoscopy. Thoracotomy may thereby be avoided.