Is a tracheoesophageal fistula management still a challenge in low resource setting? Case report of rare type D tracheoesophageal fistula and literature review

Abstract

Management of the common TEF cases have been with low promising outcomes in low resourced countries as compared to developed countries. Type D Tracheoesophageal fistula is a most rare condition whose management experience, challenges and outcomes are not adequately documented especially in developing countries. We are presenting 19-day old male delivered at term with a birth weight of 4.0 kg. The patient presented with features suggesting of Type C TEF and was successful managed after intraoperative diagnosed as type D TEF. Close monitoring postoperatively was a priority. The successful surgical experience from this case highlights the approach and perioperative management of type D TEF while advancing to minimal invasive in low resource settings with neonatal ICU care. We recommend that, surgical management to be done as earlier as possible as the patient diagnosed with Type D TEF has higher risk of gastric aspirates to the airways. Post operatively, early extubating, early initiation of feeding and Intravenous fluids principles as highlighted in this case is advised.