Undiagnosed H-type tracheo-oesophageal fistula resulting in failed ventilation in an infant with Down’s syndrome

Undiagnosed H-type tracheo-oesophageal fistula resulting in failed ventilation in an infant with Down’s syndrome

Published: 27 Mar 2014

© Anaesthesia Cases / 2014-0065 / ISSN 2396-8397

Authors

Dr Adil Butt [1]
Dr Terence Montague [2]
  • [1] Specialist Registrar, Anaesthesia & Intensive care, St. Vincents University Hospital, Dublin, Ireland
  • [2] Consultant, Anaesthesia & Intensive Care, Our Lady's hospital for Sick children, Crumlin, Dublin, Ireland

Summary

We present a 6-month-old male infant with Down's syndrome with an undiagnosed H-type tracheo-oesophageal atresia discovered on induction of general anaesthesia for an elective posterior sagittal anorectoplasty procedure for imperforate anus. Mechanical ventilation was not possible after endotracheal intubation. Rigid bronchoscopy after three failed attempts to ventilate the lungs revealed a large tracheo-oesophageal fistula.

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